Prospective Evaluation of Factors Associated with Arteriovenous Fistula Primary Failure and Complications in Hemodialysis Patients: A Single Center-Study

Abstract

Aim: The objective of this study was to analysis factors affecting arteriovenous fistula patency, to improve access outcome. Methods& Patients: Patients (n=290) were enrolled in our prospective observational study. Demographic, clinical, and operative variables were compared between those with and without NAVF function loss. In addition, we evaluated the distribution and complication of NAVF and its association with different factors. All statistical analyses were performed with the use of appropriate SPSS software package, version 24.0. Results: We found 96.5% (n=280) of patients had NAVFs, among them 67.9% (190/280) of patients had upper NAVFs, followed by lower NAVFs 32.1% 90/280), while 3.4% (10/290) of patients had depended on a cuff catheter. The most frequent complication post NAVF creation was thrombosis (11.4%), followed by noninfectious fluid collections (9.3%), infection (6.4%), Limp edema (4.3%), Aneurysmal degeneration (3.2%), arterial steal syndrome (2.5%) and venous hypertension (1.8%). History of dialysis catheter used AVF location and absent intraoperative thrill were independently associated with loss of NAVF primary patency. There was a statistically significant increase in the number of steal syndrome in patients who had diabetes mellitus (P value= 0.021) and in patients who had age >65 years (P value 0.002), while female gender was not (P value= 0.122). History of catheter used (P = 0.02), previous AVF procedure (P= 0.01), and present of non-infection fluid (P = 0.00) were found significantly increase the infection rate of NAVF. Conclusions: Identifying risk factors affecting AVF patency is crucial. Early and timely treating complications post AVF is essential for proper management and maturation.