Complications of permanent vascular access in hemodialysis patients

Abstract

Background Vascular access (VA) complications are still considered a significant cause of morbidity and mortality in hemodialysis (HD) patients. The research aimed to study the complications of permanent VA in HD patients: single-center experience. Patients and methods This was a 1-year prospective, observational study conducted in a HD Unit, Department of Nephrology in 2018. 230 HD patients were recruited for the study, and they were subjected to clinical examination in each HD session. Culture and sensitivity of a swab sample of the VA was performed to confirm the diagnosis of infection. Also, Doppler ultrasound was used to evaluate the VA when there had been a suspicion of complications. Data were analyzed using the software Statistical Package for The Social Sciences. Results Arteriovenous fistula (AVF) was the predominant VA, and radiocephalic AVF was the most common type, followed by the brachiocephalic type. The most frequent complication was aneurysm (39.6%), followed by thrombosis (7%), stenosis (5.2%), infection (4.3%), and arterial steal syndrome (2.2%). Thrombosis was the leading cause of AVF failure, and antiplatelet therapy was a protective factor from thrombosis. Infection was the second cause of VA failure and Staphylococcus aureus infection was the most common type. Elbow AVF was considered as a predisposing risk factor of arterial steal syndrome. Conclusion VA complications are not rare, and they could cause VA failure. So, it is necessary to make more efforts and work as a multidisciplinary team.