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A multicentre analysis of the outcome of arteriovenous fistula in maintenance haemodialysis
Author(s) -
Jothi Swathi,
KG Hareesh,
Lesley Nancy,
Vijayan Madhusudan,
Haridas Anupama Sneha,
Mathew Milly,
Parthasarathy Rajeevalochana,
Sundarajan Saravanan,
P Nagarajan,
Kumaraswamy Latha,
Abraham Georgi
Publication year - 2020
Publication title -
seminars in dialysis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.899
H-Index - 78
eISSN - 1525-139X
pISSN - 0894-0959
DOI - 10.1111/sdi.12907
Subject(s) - medicine , arteriovenous fistula , hemodialysis , dialysis , diabetes mellitus , cardiology , fistula , brachial artery , surgery , blood pressure , end stage renal disease , kidney disease , endocrinology
Arteriovenous fistulas (AVF) are the preferred choice for vascular access in hemodialysis. We aim to identify factors that may contribute to AVF failure. Methods: Data regarding AVF survival were collected from 441 patients. All AVFs were either radial or brachial, of the end‐to‐side variety. Parameters studied were age, gender, diabetes mellitus, hypertension prior to end‐stage kidney disease (ESKD), site of fistula, blood flow rate, venous pressure, dialysis vintage and frequency, needle gauge used during dialysis, year of fistula creation, and details of fistula failure. Findings: The 6‐month, 1‐year and 2‐year AVF survival rates were 98.41%, 95.01%, and 89.57%. Failure rates were 17.2%, 5.5%, 26.8%, and 14.4% for dominant radial, non‐dominant radial, dominant brachial and non‐dominant brachial respectively ( P < 0.001). Using a larger needle size had better AVF survival rate ( P < 0.05). All other factors had no significant correlation with AVF failure. Conclusion: There were no statistically significant differences in AVF patency with respect to gender, age, blood flow rate, presence of diabetes mellitus or systemic hypertension. A distally placed AVF in the nondominant arm had the best survival rate. Using a larger needle size, specifically 15G during dialysis, was associated with lowest AVF failure.