Premium
Incidence of arteriovenous fistula closure due to high‐output cardiac failure in kidney‐transplanted patients
Author(s) -
Schier Tabea,
Göbel Georg,
Bösmüller Claudia,
Gruber Ingrid,
Tiefenthaler Martin
Publication year - 2013
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/ctr.12248
Subject(s) - medicine , shunt (medical) , ligature , fistula , hemodialysis , arteriovenous fistula , surgery , volume overload , retrospective cohort study , heart failure , cardiology
Background Some hemodialysis patients develop arteriovenous (AV) fistulas with high flows. This volume overload can result in high‐output cardiac failure. To date, predisposing access flow rates are unknown. Methods A retrospective study of all kidney‐transplant recipients at the Medical University of Innsbruck ( MUI ) from 2005 to 2010 included 797 patients with the following criteria: previous hemodialysis with a native AV fistula or a graft, sufficient function of the kidney transplant up to the time of the data analysis, and follow‐up care at the MUI . Results Twenty‐nine of the 113 patients (25.7%) needed an AV fistula closure, mostly because of symptoms of cardiac failure. The mean shunt flow in the intervention group was 2197.2 mL/min, whereas the mean shunt flow in the non‐intervention group was only 850.9 mL/min. Shunt closures were most frequently made in patients with upper‐arm shunts (41.7%). Conclusion The necessity of shunt closure is not a rarity. Patients who underwent an AV fistula ligature had high access flows with about 2200 mL/min. As the symptoms of cardiac failure greatly improved after shunt closure, patients with high access flow may benefit from such an intervention.