Predictors of recurrent arteriovenous fistula stenosis in Saudi patients undergoing hemodialysis

Saudi Med J. 2022 Jun;43(6):592-598. doi: 10.15537/smj.2022.43.6.20220192.


Objectives: To identify predictors of recurrent arteriovenous fistula (AVF) stenosis. It also seeks to calculate the average primary patency duration in Saudi patients undergoing hemodialysis.

Methods: A retrospective case-control study was conducted at a tertiary care hospital in Riyadh. Data from 180 patients who had undergone angioplasty between May 2009 and May 2020 were analyzed. Following the inclusion/exclusion criteria, 99 patients were included. Based on the presence or absence of recurrent AVF stenosis, the patients were divided into cases and controls, respectively. Recurrence was defined as an occurrence of stenosis within <12 months of a previous stenotic event, or patients who had >3 total stenotic events. Clinical, radiological, and laboratory variables were collected and subjected to multivariate binary regression analysis to assess the odds of a recurrence of fistula stenosis.

Results: A total of 29 patients were categorized as cases, while 70 patients were categorized as controls. The median primary patency duration was found to be seven months. Multivariate binary regression analysis revealed higher levels of serum calcium (p=0.012) and BMI (p=0.007) in patients with recurrent stenosis. A positive association was also observed between the use of antiplatelets (0.039) and recurrent stenosis.

Conclusion: Higher levels of corrected calcium, BMI, and the application of antiplatelet therapy were found to be predictors of recurrent AVF stenosis. No other traditional variables were found to be significant.

Keywords: angioplasty; arteriovenous fistula; renal replacement therapy recurrent stenosis; vascular access.

MeSH terms

  • Angioplasty, Balloon*
  • Arteriovenous Fistula* / etiology
  • Arteriovenous Fistula* / therapy
  • Arteriovenous Shunt, Surgical* / adverse effects
  • Calcium
  • Case-Control Studies
  • Constriction, Pathologic / etiology
  • Constriction, Pathologic / surgery
  • Humans
  • Renal Dialysis / adverse effects
  • Retrospective Studies
  • Saudi Arabia / epidemiology
  • Treatment Outcome
  • Vascular Patency


  • Calcium