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Meta-Analysis
, 28 (6), 583-9

Radiocephalic Wrist Arteriovenous Fistula for Hemodialysis: Meta-Analysis Indicates a High Primary Failure Rate

Affiliations
Meta-Analysis

Radiocephalic Wrist Arteriovenous Fistula for Hemodialysis: Meta-Analysis Indicates a High Primary Failure Rate

P P G M Rooijens et al. Eur J Vasc Endovasc Surg.

Abstract

Objective: To improve the precision of the estimates of primary failure rates and primary and secondary 1 year patency of radial-cephalic arteriovenous fistulas (RCAVF) for hemodialysis.

Design: Meta-analysis.

Materials and methods: A Medline search was performed of the English language medical literature between January 1970 and October 2002. Key words that were searched included radiocephalic fistula, arteriovenous shunt, Brescia-Cimino fistula and patency. Primary failure, primary and secondary patency rates were analysed using the standard mixed effects model, which allows for variability between the different studies.

Results: Eight prospective and 30 retrospective studies were included. The analysis showed a pooled estimated primary failure rate of 15.3% (95% CI: 12.7-18.3%). In addition, the pooled estimated primary and secondary patency rates of 62.5% (95% CI: 54.0-70.3%) and 66.0% (95% CI: 58.2-73.0%), respectively, were calculated. Subgroup analysis concerning various study characteristics, including study year, gender and age, did not reveal statistically significant differences.

Conclusion: Although, the autogenous RCAVF is considered to be the primary choice for vascular access, this meta-analysis indicates a high primary failure rate and only moderate patency rates at 1 year of follow-up.

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