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Am J Kidney Dis. 2004 May;43(5):e17-22.

Arteriovenous fistula-associated high-output cardiac failure: a review of mechanisms.

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Division of Nephrology, University of British Columbia, Vancouver, British Columbia, Canada.


High-output cardiac failure can be a rare complication of high-output arteriovenous fistula. The authors present a case in which a hemodialysis patient with a high-flow arteriovenous fistula has cardiac failure that improves with fistula closure. The hemodynamic effects of a fistula are reviewed, and the hemodialysis literature regarding high-output cardiac failure is summarized. To gain insight into the problem of high-output cardiac failure, research efforts should focus on the prospective monitoring of high-access flows.

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