The type of vascular access and the effectiveness of haemodialysis

Abstract

Introduction: Chronic kidney disease has been perceived in recent years as a disease of civilisation. Patients with stage 5 or 4 renal failure require renal replacement therapy. Ninety per cent of patients with renal failure are treated using haemodialysis. In order to perform extracorporeal blood purification procedures, it is necessary to establish a vascular access for the patient. The efficiency of haemodialysis can be determined based on the urea reduction rate and dialyser’s urea clearance. One of the main factors influencing the adequacy of dialysis is the type of vascular access. Aim of the study: To ascertain whether the type of vascular access influences the effectiveness of haemodialysis. Material and methods: The study included 61 patients dialysed at the University Hospital in Cracow in the period from December 2018 to February 2019. The study compared potassium values before and after haemodialysis, the degree of urea removal, and the urea clearance of the dialyser. Results: The best results were obtained by patients dialysed using an arteriovenous fistula; for those patients the urea reduction ratio (URR) was 0.7 and the Kt/V was 1.7; the worst values were found for patients dialysed using a Gero-trex artificial vessel. Conclusions: The type of vascular access affects the effectiveness of haemodialysis.