Factors Associated with Fistula Secondary Failure in Patients on Hemodialysis

Ibrahim, Ahmed; Farrag, Safwat; El Ashkar, Ahmed; Aboul Fotouh, Ahmed; El Shorbagy, Mohamed

doi:10.21608/ejhm.2018.9291

Factors Associated with Fistula Secondary Failure in Patients on Hemodialysis

Document Type : Original Article

Authors

¹ Internal Medicine & Nephrology, Faculty of Medicine Al-Azhar University.

² Radiology Department, Faculty of Medicine Al-Azhar University.

³ Clinical Pathology Department, Faculty of Medicine Al-Azhar University.

10.21608/ejhm.2018.9291

Abstract

Background: Native arteriovenous (AV) fistulas, which are the most commonly used access line, enable sufficient and repeated hemodialysis (HD) applications and improves the rate of survival and quality of life in patients with end-stage renal disease (ESRD) when performed timely in an appropriate anatomic location using a fine technique. Objectives: We aimed to assess factors responsible for fistula secondary failure in patients on hemodialysis. Patients and Methods: Thirty patients with end stage renal disease (ESRD) on regular HD were included. All patients underwent history taking, clinical examination and ultrasound examination was carried out for all patients to assess AVF and factors associated with its patency and failure. Results: There was no statistically significant differences between group I and group II as regards to age, BMI, HD duration and AVF age (p-value >0.05). There was statistically high significant difference between patients with well functioning AVF (group I) and patients with malfunctioning (secondary failed) AVF (group II) as regarding SVP and mean arterial blood pressure (P-value < 0.01) and there was statistically significant difference between group I and group II as regarding DVP (p-value < 0.05). There was statistically high significant difference between group I and group II as regarding venous diameter and FV (P-value < 0.01), while there was no statistically significant difference between group I and group II as regarding arterial diameter (P-value > 0.05). There was statistically high significant difference between group I and group II as regarding hemoglobin & dialysis adequacy (Kt/V) (P-value < 0.01). Conclusion: The native AVF is the vascular access of choice for patients who require hemodialysis: it lasts longer and is associated with fewer complications than other types of vascular access; for hemodialysis patients, these benefits translate into better quality of life and longer survival. The result of this study showed a significant positive correlation between access blood flow (Qa) and Kt/V. This confirm the importance of well-functioning non stenotic AVF in delivering adequate dialysis.

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