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Patency and effectiveness of vascular access for hemodialysis patients: a descriptive study
1Department of Cardiovascular Surgery, Ağrı Education and Research Hospital, Ağrı, Turkiye.
Insights
Vascular access complications like infection and thrombosis are critical for dialysis patients. Brachial fistulas were most common, but age over 65 impacted fistula maturation and patency.
Area of Science:
- Nephrology
- Vascular Surgery
- Dialysis Access Management
Background:
- Vascular access is crucial for dialysis-dependent patients.
- Complications significantly impact patient quality of life.
Purpose of the Study:
- Evaluate infection rates of permanent catheters.
- Assess arteriovenous fistula (AVF) thrombosis, maturation, and patency by location.
Main Methods:
- Retrospective study of 75 chronic kidney disease (CKD) patients.
- Analyzed 109 AVFs (distal radiocephalic, proximal radiocephalic, brachial) and 9 permanent catheters.
- Compared outcomes based on fistula location and patient age.
Main Results:
- Permanent catheter infection rate was 4% among users.
- Thrombosis rates: 41.3% distal radiocephalic, 2.7% proximal radiocephalic, 8.0% brachial.
- Patients <65 years had shorter AVF maturation times than those >65 years.
Conclusions:
- Brachial AVFs were the most frequent access (38.7%).
- Age >65 negatively affects AVF maturation and patency.
- No significant difference in maturation times across AVF locations.
Introduction:
Vascular access is one of the most important issues affecting the quality of life of patients who are dialysis-dependent.
Aim:
The aim of our study was to determine the infection rates of permanent catheters. We also evaluated the thrombosis, maturation time, and patency rates of arteriovenous fistulas based on their location in the arm in dialysis patients.
Material And Methods:
The study included a total of 109 arteriovenous fistulas and 9 permanent catheters of 75 dialysis-dependent chronic kidney disease (CKD) patients from 3 different dialysis centers; 66 of the fistulas were patent and 43 were thrombosed. Arteriovenous fistulas were examined in three groups according to their location in the forearm: distal radiocephalic, proximal radiocephalic, and brachial region.
Results:
66.7% of the participants had used at least one permanent tunneled catheter in their lifetime. Of those who had used at least one permanent catheter (n = 50), 6% experienced a permanent catheter infection. Among the 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. Those under the age of 65 had shorter maturation times compared to those over the age of 65 (p < 0.05).
Conclusions:
The most frequently used dialysis access was brachial region arteriovenous fistulas at 38.7%. There was no significant difference in maturation times between distal, proximal, and brachial region arteriovenous fistulas. Age above 65 negatively affects both fistula maturation and primary patency. The rate of permanent catheter infection among patients who had used at least one permanent catheter in their lifetime was found to be 4%.
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