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High-flow arteriovenous fistula and hemodynamic consequences at 1 year after kidney transplantation

Nicolas Keller1, Alexandra Monnier2, Sophie Caillard1

  • 1Department of Nephrology and Transplantation, Nouvel Hôpital Civil, Strasbourg, France.

Seminars in Dialysis
|November 2, 2021
PubMed

Insights

Kidney transplant patients with high-flow arteriovenous fistulas showed larger left ventricular diameters. While not pathological, these findings highlight potential cardiovascular impacts of high-flow fistulas post-transplant.

Area of Science:

  • Nephrology
  • Cardiology
  • Transplantation

Background:

  • Cardiovascular complications are a concern after kidney transplantation.
  • Arteriovenous fistulas (AVFs) are crucial for hemodialysis access.
  • Limited data exist on the cardiovascular effects of AVF flow rates post-transplant.

Purpose of the Study:

  • To investigate the cardiovascular impact of arteriovenous fistula flow in kidney transplant recipients.
  • To compare cardiac parameters based on different fistula flow categories.

Main Methods:

  • Prospective, single-center cohort study of 49 kidney transplant patients with functional fistulas at 1 year.
  • Clinical work-up, biological analysis, Doppler ultrasonography for fistula flow, and echocardiography.
  • Comparison of echocardiography parameters between normal-flow and high-flow fistula groups (absolute and relative).

Main Results:

  • High-flow fistulas were present in 69% of patients.
  • Significantly larger left ventricular end-diastolic and systolic diameters were observed in high-flow fistula patients compared to normal-flow.
  • These differences were also significant between absolute and relative high-flow subgroups.

Conclusions:

  • High-flow arteriovenous fistulas in kidney transplant recipients are associated with increased left ventricular dimensions.
  • These observed increases in ventricular diameters were statistically significant but not considered pathological.
  • Further monitoring of cardiovascular parameters in relation to fistula flow is warranted.
Abstract

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