Abstract
A Retrospective Analysis of Arteriovenous Fistulas as Hemodialysis Access Surgery in the Perspective of KDOQI (Kidney Disease Outcomes Quality Initiative) Guidelines
Highlights
There is an enormous increase in the number of renal transplants, which is the best treatment option for chronic renal failure (CRF) patients, hemodialysis continues to be the main treatment method
Materials and methods: A total of 54 native arteriovenous fistula (AVF) surgical procedure was created, by one general surgeon experienced in kidney transplantation, between January 2014 and January 2018, as hemodialysis access surgery for 51 CRF patients referred from Nephrology Department at Umraniye Training and Research Hospital of Health Sciences University
The patency rate of AVF was 92.5% during follow-up period. Both nephrologists and surgeons should follow the clinical guidelines set by Kidney Disease Outcomes Quality Initiative (KDOQI)
Summary
There is an enormous increase in the number of renal transplants, which is the best treatment option for chronic renal failure (CRF) patients, hemodialysis continues to be the main treatment method. Autologous or native arteriovenous fistula (AVF) provides the best hemodialysis access technique because of its relatively low complication rate, longer-term patency and lower costs, when compared to arteriovenous synthetic graft and central venous catheter placement [1]. Fistula First policy has been supported by the renal community all over the world. These guidelines emphasizes the importance of creating an AVF at the most distal part of the non-dominant arm, allowing a more proximal site for a new fistula creation in case of any primary failure or complication. Comorbidities such as diabetes, vascular diseases and atherosclerosis, diameters of the lumen of vein and artery, surgical technique applied and surgeon’s experience are all among the factors affecting patency. Preoperative physical examination of the arm is mandatory, and colored Doppler ultrasound for mapping of the vessels can be done for selected cases with previous one or multiple AVF failures or when physical exam is inconclusive [4]
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