Successful use of arterio-venous graft for hemodialysis in patient with hemophilia

Hemodialysis (HD) is not the preferred approach for dialysis in patients with hemophilia. HD in such patients can possess a high risk of bleeding from arterio-venous cannulation and hence peritoneal dialysis is the first choice in patients with hemophilia. The bleeding risk can be overcome by the prophylactic administration of factor VIII, which is a very costly solution. Here, we present a case of hemophilia with successful HD using an arterio-venous graft averting the need for factor VIII. We review the literature on epidemiology and risk factors for chronic kidney disease in patients with hemophilia. We also discuss the dialysis and arterio-venous graft options. In patients with hemophilia who are not candidates for peritoneal dialysis, tri-layered arterio-venous grafts offer distinct advantages.