SciELO - Scientific Electronic Library Online

vol.37 issue2Renal function is similar in solitary kidneys from patients with and without diabetesAnaemia and fever in Kidney transplant. The role of human parvovirus B19 author indexsubject indexarticles search
Home Pagealphabetic serial listing  

Services on Demand




Related links

  • On index processCited by Google
  • Have no similar articlesSimilars in SciELO
  • On index processSimilars in Google


Nefrología (Madrid)

On-line version ISSN 1989-2284Print version ISSN 0211-6995


BAENA, Laura et al. Establishment of buttonhole technique as a puncture alternative for arteriovenous fístulas. experience of a centre over 3 years. Nefrología (Madr.) [online]. 2017, vol.37, n.2, pp.199-205. ISSN 1989-2284.


The buttonhole (BH) puncture technique for arteriovenous fistulas is an alternative to the classical staggered puncture.


We present 3 years’ results incorporating the BH puncture technique for arteriovenous fistulas in our dialysis unit.

Material and methods:

Twenty-two patients were started on BH technique, 15 men and 7 women (mean age: 62 years; SD: 12), with time spent on dialysis when starting the BH technique of 34 months (SD: 34, median: 27, range: 3-136). Seven patients received acenocoumarol and 9 antiplatelet agents. The vascular access median time at the beginning of the technique was 27 months (range: 3-252).


Between 5 and 8 consecutive dialysis sessions were necessary to achieve a proper tunnel puncture. No patient suffered major complications. The average time on BH technique until December 2015 was 12 months (SD: 10, median: 9, range: 1-45). By the end of the study, 5patients were performing self-puncture. Haemostasis times post-dialysis were reduced from 18.6 min (SD: 8, prior to the BH technique), to 12.2 minutes (SD: 3 after BH) (P = .0005).


The BH technique is an alternative puncture technique for dialysis patients. Self-puncture and reduction in hemostasis time are potential beneficial aspects. A greater diffusion of this technique in the hemodialysis units would allow it to be better applied. A highly motivated nursing staff is key and a necessary condition for its implementation.

Keywords : Button-hole; Haemodialysis; Haemostasis; Self-puncture.

        · abstract in Spanish     · text in Spanish     · Spanish ( pdf )