III. NKF-K/DOQI Clinical Practice Guidelines for Vascular Access: Update 2000  American Journal of Kidney Diseases  Volume 37, Issue 1, Pages S137-S181 (January 2001) DOI: 10.1016/S0272-6386(01)70007-8 Copyright © 2001 Terms and Conditions

Fig III 1. Arterial and venous pressure monitoring. American Journal of Kidney Diseases 2001 37, S137-S181DOI: (10.1016/S0272-6386(01)70007-8) Copyright © 2001 Terms and Conditions

Fig III 2. Access and cardiopulmonary recirculation. The figure shows a simplified sketch of the dialysis circuit with an AV access depicting local access recirculation (dotted line with arrows) and cardiopulmonary recirculation. Cardiopulmonary recirculation is associated with an arteriovenous difference in BUN (100 versus 95 mg/dL) which results from dialyzed blood “short circuiting” the capillaries where blood is “refilled” with urea (95 to 99.4 mg/dL); this “short circuiting” decreases dialysis efficiency. This sketch includes regional blood flow inequalities and the resulting impact on BUN in veins draining poorly perfused (BUN >99.4 mg/dL) and well-perfused (BUN <99.4 mg/dL) areas. This venovenous disequilibrium increases late in dialysis when greater differences develop in urea concentrations among the regions of the body, a consequence of varying urea washout (regional blood flow model).134 Reprinted with permission.134 American Journal of Kidney Diseases 2001 37, S137-S181DOI: (10.1016/S0272-6386(01)70007-8) Copyright © 2001 Terms and Conditions