Skip to main page content
Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
, 7 (11), 1782-1787

Primary Failure of the Arteriovenous Fistula in Patients With Chronic Kidney Disease Stage 4/5

Affiliations

Primary Failure of the Arteriovenous Fistula in Patients With Chronic Kidney Disease Stage 4/5

Nikola Gjorgjievski et al. Open Access Maced J Med Sci.

Abstract

Background: An Arteriovenous fistula (AVF) is a creation of the natural blood vessels. It is a "gate of life" for the patients on hemodialysis.

Aim: The study aimed to analyze the predictors for primary failure of AVF such as gender, age, number and location of AVF, and primary renal disease in patients with chronic kidney disease (CKD) stage 4/5.

Material and methods: The medical records of 178 created arteriovenous fistulae in patients with CKD stage 4/5, were retrospectively studied. Primary failure of AVF was defined as thrombosis or inability for cannulation of AVF within 3 months. Adequate maturation of AVF was defined as successful cannulation of AVF treatment and blood flow of > 600 ml/min.

Results: The mean age of the patients was 59.75 ± 14.65 years, and 65.16% (116/178) were men. Adequate maturation of AVF was achieved in 83.71% (149/178). Primary failure of AVF occurred in 16.29% (29/178) of the created fistulae, while 10.11% (18/178) had early thrombosis. The distal arteriovenous fistulae were significantly more frequently created in male patients (51 vs 18; p = 0.015). The female patients were significantly older than the male patients (63.27 vs 57.86 years; p = 0.018).

Conclusion: Male gender was associated with better maturation of AVF. The age, number and location of AVF, and primary renal disease in patients with CKD stage 4/5 were not associated with primary failure of AVF.

Keywords: Arteriovenous fistula; Chronic kidney disease; Doppler ultrasound; Hemodialysis; Primary failure.

Figures

Figure 1
Figure 1
The number of patients with RRT per year for the Republic of Macedonia; *data from ERA-EDTA registry (annual reports); *unpublished registry data for 2012 and 2013 analyzed from national source; *HD (hemodialysis); *PD (peritoneal dialysis); *Tx (transplantation); *Total
Figure 2
Figure 2
Distribution of permanent types of vascular access between 2002 and 2018 at the University Hospital of Nephrology, Skopje, Republic of Macedonia. *AVF – arteriovenous fistula; *TCC- tunnelled central venous catheters; *unpublished registry data for 2002 to 2018 analysed from a national source
Figure 3
Figure 3
Blood flow of AVF after 28 days of creation
Figure 4
Figure 4
Location of a. radial and v. cephalic at the distal forearm site
Figure 5
Figure 5
Creation of anastomosis by a. radial and v. cephalic at the distal forearm site
Figure 6
Figure 6
Primary outcome (adequate maturation and primary failure) of AVF in the three different locations on the forearm. *AVF – arteriovenous fistula

Similar articles

See all similar articles

References

    1. Couser WG, Remuzzi G, Mendis S, Tonelli M. The contribution of chronic kidney disease to the global burden of major noncommunicable diseases. Kidney international. 2011;80(12):1258–70. https://doi.org/10.1038/ki.2011.368 PMid: 21993585. - PubMed
    1. Jha V, Garcia-Garcia G, Iseki K, et al. Chronic kidney disease: global dimension and perspectives. Lancet. 2013;382(9888):260–272. https://doi.org/10.1016/S0140-6736(13)60687-X. - PubMed
    1. Gjorgjievski N, Stojanoska A, Smokovska A, Dejanov P, Spasovski G. Challenges Facing the Improvement of Kidney Transplantation - Issues in a Developing Country, Republic of Macedonia. Bantao. 2018;16(1):1–4.
    1. Brescia MJ, Cimino JE, Appel K, Hurwich BJ. Chronic hemodialysis using venipuncture and a surgically created arteriovenous fistula. N Engl J Med. 1966;275(20):108992. https://doi.org/10.1056/NEJM196611172752002 PMid: 5923023. - PubMed
    1. National Kidney Foundation. KDOQI clinical practice guidelines and clinical practice recommendations for vascular access. Am J Kidney Dis. 2006;48(suppl 1):S176–S322. https://doi.org/10.1053/j.ajkd.2006.04.029 PMid: 16813989. - PubMed

LinkOut - more resources

Feedback