Buttonhole cannulation in adult patients on hemodialysis: an increased risk of infection?

Nephrol Nurs J. Sep-Oct 2010;37(5):491-8, 555; quiz 499.


In the U.S., the rope-ladder technique for cannulating arteriovenous fistulas has been the technique of choice in patients on hemodialysis. Recently, the buttonhole cannulation technique has been gaining popularity. Based upon review of the literature and developments in clinical practice, an important question is posed regarding infection rates in those utilizing this technique. This article discusses those findings, presents a change in practice, and provides recommendations for practice.

Publication types

  • Review

MeSH terms

  • Adult
  • Catheterization / adverse effects*
  • Education, Nursing, Continuing
  • Humans
  • Infections / epidemiology*
  • Renal Dialysis / adverse effects*
  • Risk Factors