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Arteriovenous fistulas thrombosis in hemodialysis patients with COVID-19

Geoffroy Desbuissons1,2, Arthur Michon1, Philippe Attias3

  • 1Nephrology Department, Kremlin Bicêtre University Hospital, Assistance Publique Hôpitaux de Paris, Le Kremlin Bicêtre, France.

The Journal of Vascular Access
|February 24, 2021
PubMed

Insights

Coronavirus disease 2019 (COVID-19) significantly increases mortality in hemodialysis patients. Arteriovenous fistula (AVF) thrombosis is a severe complication in these patients, contributing to increased mortality and accelerated death.

Area of Science:

  • Nephrology and Vascular Surgery
  • Infectious Diseases and Critical Care

Background:

  • Coronavirus disease 2019 (COVID-19) is linked to high mortality, particularly in end-stage renal disease (ESRD) and hemodialysis (HD) patients.
  • While thrombosis is a known complication in COVID-19 patients, arteriovenous fistula (AVF) thrombosis remains underreported.
  • AVF thrombosis poses a significant threat to patient outcomes in HD populations.

Purpose of the Study:

  • To characterize the clinical presentation and prognosis of arteriovenous fistula (AVF) thrombosis in hemodialysis patients with COVID-19.
  • To investigate the impact of AVF thrombosis on mortality and treatment outcomes in this vulnerable patient group.

Main Methods:

  • A cohort study was conducted in the Ile de France region between March 11th and April 30th, 2020.
  • Data were collected from seven dialysis units and interventional vascular departments, focusing on COVID-19 hemodialysis patients with AVF thrombosis.
  • Patient characteristics were analyzed through a retrospective review of medical records.

Main Results:

  • Seventeen COVID-19 hemodialysis patients with AVF thrombosis were included (median age 69 years; 59% male; 59% diabetic; 88% hypertensive).
  • The mortality rate among these patients was high at 47%.
  • Declotting procedures were successful in 64% of cases, but 36% experienced early relapse.

Conclusions:

  • Arteriovenous fistula (AVF) thrombosis is a critical complication in COVID-19 hemodialysis patients.
  • This complication contributes to the overall severity of illness and may accelerate mortality.
  • Further research is needed to optimize management strategies for AVF thrombosis in this population.
Abstract

Keywords:
Arteriovenous fistulaCOVID-19heamodialysismortalitythrombectomythrombosis

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