ARTERIOVENOUS FISTULA FOR HEMODIALYSIS IN RELATION TO THE TIMING OF CREATION: ANALYSIS OF KEY FACTORS.

Abstract

Timely creation of an arteriovenous fistula is not always feasible. The aim was to determine the key factors for functionality and maturation of arteriovenous fistulas in relation to timing of its creation. The research was conducted at the Department of Nephrology and Dialysis, Kragujevac University Clinical Center, Kragujevac, Serbia, in patients who had had a fistula surgically created over a period of fifteen years. A total of 1089 patients were registered. All clinical and biochemical parameters that were of interest for this study were analyzed. The group of patients with fistulas created before the start of hemodialysis was statistically different from the group of patients whose fistulas were created after the start of hemodialysis according to vein lumen (p=0.005), systolic blood pressure (p<0.001), total cholesterol (p<0.001), HDL cholesterol (p=0.008) and LDL cholesterol (p<0.001). Predictive parameters of the initial dysfunction were vein diameter (p=0.004), cholesterol (p=0.008) and LDL cholesterol (p=0.033), while the maturation parameter was systolic blood pressure (p=0.042). In conclusion, predictive parameters of initial fistula dysfunction are vein diameter, cholesterol and LDL cholesterol, while systolic blood pressure is most important for maturation.