#2885 Thrombosis complicating the first native arteriovenous fistula: what are the risk factors?

Abstract

Abstract Background and Aims The native arteriovenous fistula is considered the best vascular access for hemodialysis, whose ultimate complication is thrombosis. The risk factors for this complication are multiple. The aim of our work is to determine the risk factors for thrombosis of the first created native AVF. Method This is a retrospective descriptive study of 65 patients over 18 years of age and hemodialyzed in our department who benefited of the confection of a native arteriovenous fistula at the same hospital. Results Arteriovenous fistula thrombosis occurred in 41.53% of patients with an average age of 49.4 years and a sex ratio M/F=3.5. 59.2% of arteriovenous fistulae were distal versus 40.7% proximal, divided into humerocephalic (29.6%) and humerobasilic (11.1%). AVF thrombosis occurred after a mean duration of 3.19 years after its confection [01 months, 13 years]. 25.9% of arteriovenous fistulae had not yet been punctured. 63% of patients were smokers, 55.6% were diabetics, 74.1% were hypertensive and 66.7% were cardiac with predomination of ischemic etiology in 29.6%. 44.4% of patients had obliterative arteriopathy of the lower limbs, 25.9% of whom were amputees. Patients had been on dialysis for an average of 4.4 years [01 months, 13 years], with diabetic nephropathy predominating at 51.9%. All patients were on antiplatelet therapy and 7.4% on anticoagulation. 11.1% had perdialytic hypotension. Multivariate statistical analysis revealed a significant correlation between anemia, diabetes and the occurrence of thrombosis (respectively p = 0.03; p = 0.024). Conclusion Patients with arteriovenous fistula thrombosis have multiple cardiovascular risk factors. Diabetes and anemia remain the main predictive factors for thrombosis.