Outcomes of Distal Radio-Cephalic Fistula for Hemodialysis

International Journal of Medical Science

© 2024 by SSRG - IJMS Journal

Volume 11 Issue 3

Year of Publication : 2024

Authors : Ali alyaseen, Ghanem Ahmad, Suliman Ali

10.14445/23939117/IJMS-V11I3P103

How to Cite?

Ali alyaseen, Ghanem Ahmad, Suliman Ali, "Outcomes of Distal Radio-Cephalic Fistula for Hemodialysis," SSRG International Journal of Medical Science, vol. 11,  no. 3, pp. 11-15, 2024. Crossref, https://doi.org/10.14445/23939117/IJMS-V11I3P103

Abstract:

Although a distal radio-cephalic fistula is still recommended as the primary access option in patients undergoing chronic dialysis, it is associated with a high frequency of failure. Objective: The aim of this study was to evaluate the one-year patency rates of distal radio-cephalic arteriovenous fistula. Patients and Methods: A retrospective observational descriptive study was conducted for the period of one year (July 2021 - June 2022) at Tishreen University Hospital in Lattakia-Syria. The study included a group of patients attending the Department of Vascular Surgery and Nephrology who underwent the creation of an arteriovenous fistula to provide vascular access for hemodialysis. Results: The population of patients was predominantly males (57.4%), with a mean age of 51.85±14.5 years. The most common primary diseases causing chronic kidney disease were as follows: hypertension (42.6%), diabetes mellitus (31.5%), and glomerulonephritis (16.7%). The six-month and one-year primary patency rates were 83.3% and 79.6%, respectively, with similar results for secondary patency (83.3% and 79.6%). Rates of patency were significantly higher in males than females, patients younger than 65 years, absence of diabetes mellitus or anemia or peripheral artery disease (p<0.05), without any significant correlation with using of antiplatelet drugs(p:0.2) or smoking(p:0.4). The most frequent complications were superficial wound infection (12.9%) and primary failure (12.9%). Conclusion: The current study demonstrated favorable results in the efficiency of distal radio-cephalic fistula as the first choice for vascular access, especially in the absence of risk factors for developing failure.

Keywords:

Diabetes mellitus, Patency rate, Peripheral artery disease, Primary failure, Syria.

References:

[1] Anton N. Sidawy, and Bruce A. Perler, Rutherford's Vascular Surgery and Endovascular Therapy, Elsevier Health Sciences, pp.1-2736, 2018.
[Google Scholar] [Publisher Link]
[2] Annual Data Report: Atlas of Chronic Kidney Disease and End-stage Renal Disease in the United States, United States Renal Data System (USRDS), 2013. [Online]. Available: https://ghdx.healthdata.org/record/united-states-renal-data-system-annual-data-report-2013
[3] Charmaine E. Lok, “Fistula First Initiative: Advantages and Pitfalls,” Clinical Journal of the American Society of Nephrology, vol. 2, no. 5, pp. 1043-1053, 2007.
[CrossRef] [Google Scholar] [Publisher Link]
[4] Boris Bikbov et al., “GBD Chronic Kidney Disease Collaboration, Global, Regional, and National Burden of Chronic Kidney Disease, 1990-2017: A Systematic Analysis for the Global Burden of Disease Study 2017,” GBD Chronic Kidney Disease Collaboration Lancet, vol. 395, pp.709-733, 2020.
[CrossRef] [Google Scholar] [Publisher Link]
[5] Jan Dominik Kampmann et al., “Prevalence and Incidence of Chronic Kidney Disease Stage 3-5- Results from KidDico,” BMC Nephrology, vol. 24, no. 17, pp. 1-9, 2023.
[CrossRef] [Google Scholar] [Publisher Link]
[6] Charmaine E. Lok et al., “KDOQI Clinical Practice Guidelines for Vascular Access: 2019 Update,” American Journal of Kidney Diseases, vol. 75, no. 4, pp. s1-s164, 2021.
[CrossRef] [Google Scholar] [Publisher Link]
[7] Ahmed A. Al-Jaishi et al., “Complications of the Arteriovenous Fistula: A Systematic Review,” Journal of the American Society of Nephrology, vol. 28, no. 6, pp. 1839-1850, 2017.
[CrossRef] [Google Scholar] [Publisher Link]
[8] Baris Afsar, and Rengin Elsurer, “The Primary Arteriovenous Fistula Failure - A Comparison between Diabetic and Non-Diabetic Patients: Glycemic Control Matters,” International Urology and Nephrology, vol. 44, pp. 575-581, 2012.
[CrossRef] [Google Scholar] [Publisher Link]
[9] T. Ernandez et al., “Risk Factors for Early Failure of Native Arteriovenous Fistulas,” Nephron Clinical Practice, vol. 101, no. 1, pp. c39- c44, 2005.
[CrossRef] [Google Scholar] [Publisher Link]
[10] Jan P. Vandenbroucke, and Frits R. Rosendaal, “End Of the Line for "Third Generation- Pill" Controversy?,” The Lancet Journal, vol. 349, pp. 1113-1114, 1997.
[CrossRef] [Google Scholar] [Publisher Link]
[11] Henricus J.T.A.M. Huijbregts et al., “Hospital Specific Aspects Predominantly Determine Primary Failure of Hemodialysis Arteriovenous Fistulas,” Journal of Vascular Surgery, vol. 45, no. 5, pp. 962-967, 2007.
[CrossRef] [Google Scholar] [Publisher Link]
[12] Osende I. Julio et al., “Blood Thrombogenicity in Type 2 Diabetes Mellitus Patients is Associated with Glycemic Control,” Journal of the American College of Cardiology, vol. 38, no. 5, pp. 1307-1312, 2001.
[CrossRef] [Google Scholar] [Publisher Link]
[13] Edward G. Lakatta, “Arterial and Cardiac Aging: Major Shareholders in Cardiovascular Disease Enterprises: Part III Cellular and Molecular Clues to Heart and Arterial Aging,” Circulation, vol. 107, no. 3, pp. 490-497, 2003.
[CrossRef] [Google Scholar] [Publisher Link]
[14] P.P.G.M. Rooijens et al., “Radiocephalic Wrist Arteriovenous Fistula for Hemodialysis: Meta-analysis Indicates a High Primary Failure Rate,” European Journal of Vascular and Endovascular Surgery, vol. 28, no. 6, pp. 583-589, 2004.
[CrossRef] [Google Scholar] [Publisher Link]
[15] Cong Cong Wu et al., “The Outcome of the Proximal Radial Artery Arteriovenous Fistula,” Journal of Vascular Surgery, vol. 61, no. 3, pp. 802-808, 2015.
[CrossRef] [Google Scholar] [Publisher Link]
[16] Firdaus A. Dekhaiya et al., “A Prospective Study of Arteriovenous Fistula Creation in Chronic Renal Failure Patients in Bhavnagar, Gujarat, western India,” International Journal of Medical Science and Public Health, vol. 5, no. 2, pp.228-232, 2016.
[CrossRef] [Google Scholar] [Publisher Link]
[17] Prasad Narayan et al., “Outcomes of Radiocephalic Fistula Created by Nephrologists,” The Journal of Vascular Access, vol. 20, no. 6, pp. 615-620, 2019.
[CrossRef] [Google Scholar] [Publisher Link]