Dialysis access−associated steal syndromes

Symptomatic hand ischemia has been reported in occur in up to 20% of patients undergoing upper-extremity dialysis access procedures, and is a common cause of postoperative steal in the patient with end-stage renal disease. The majority of dialysis access steal syndromes do not require operative intervention, but severe ischemia associated with muscle paralysis can progress to limb amputation if left untreated. In this review, patient risk factors, clinical presentation, diagnostic techniques, and management options for patients with dialysis access steal syndromes are discussed.