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[MSB-01] Patency and Effectiveness of Vascular Access For Hemodialysis Patients: A Descriptive Study
1Department of Cardiovascular Surgery, Gebze Medicalpark Hospital, Kocaeli, Türkiye.
Insights
Dialysis patients experienced high rates of arteriovenous fistula thrombosis, particularly in the distal radiocephalic region. Maturation time for arteriovenous fistulas increased with age, but varied little by location.
Area of Science:
- Nephrology
- Vascular Surgery
- Dialysis Access
Background:
- Vascular access is critical for hemodialysis patients.
- Arteriovenous fistulas (AVFs) and permanent tunneled catheters (PTCs) are common access types.
- Understanding factors influencing AVF patency, maturation, and complications is essential for optimal patient care.
Purpose of the Study:
- To investigate infection rates of permanent catheters.
- To evaluate thrombosis, maturation time, and patency rates of AVFs.
- To analyze these outcomes based on AVF location within the arm.
Main Methods:
- A study involving 75 chronic kidney disease patients undergoing dialysis.
- Included 109 AVFs and 9 PTCs across six dialysis centers.
- AVFs were categorized by location: distal radiocephalic, proximal radiocephalic, and brachial.
Main Results:
- 41.3% of patients had a thrombosed distal radiocephalic fistula; overall fistula thrombosis was 44%.
- AVF maturation averaged 38 days, with shorter times in patients under 65.
- No significant difference in maturation times was observed between AVF locations.
Conclusions:
- The distal radiocephalic fistula location is associated with a high thrombosis rate.
- Patient age is a significant factor affecting AVF maturation time.
- AVF location did not significantly impact maturation time, but did impact thrombosis rates.
Objective:
The study aimed to reveal the infection rates of permanent catheters and the thrombosis, maturation time, and patency rates of arteriovenous fistulas according to the regions in the arm in dialysis patients.
Methods:
The study included a total of 109 arteriovenous fistulas and nine permanent catheters of 75 dialysisdependent patients with chronic kidney disease from six different dialysis centers. Arteriovenous fistulas were examined in three groups according to their location in the forearm: distal radiocephalic, proximal radiocephalic, and brachial regions.
Results:
Among those undergoing dialysis with a permanent tunneled catheter (PTC; n=9), 77.8% (n=7) used a PTC by choice, while 22.2% (n=2) used it due to heart failure instead of an arteriovenous fistula. Of the participants, 66.7% (n=50) used at least one PTC in their lifetime; 6% of these patients experienced a PTC infection, while 44% had a thrombosed fistula. Among all patients, 66 of the fistulas were patent, and 43 were thrombosed. Of these patients, 41.3% had a thrombosed distal radiocephalic fistula, 2.7% had a thrombosed proximal radiocephalic fistula, and 8.0% had a thrombosed brachial fistula. No relationship was found between the number of thrombosed fistulas and smoking, obesity, sex, or chronic diseases. The maturation time of arteriovenous fistulas was on average 38 days. Those under the age of 65 had shorter maturation times compared to those over the age of 65 (p<0.05).
Conclusion:
Approximately half (41.3%) of dialysis-dependent patients had a thrombosed distal radiocephalic fistula. The maturation time of arteriovenous fistulas increases with age. There was no statistically significant difference in maturation times among distal radiocephalic, proximal radiocephalic, and brachial arteriovenous fistulas.
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