Factors responsible for fistula failure in hemodialysis patients

Abstract

Background: Autogenous arteriovenous fistula (AVF) is regarded as the first and perhaps the best choice of vascular access in hemodialysis patients. Vascular access procedures and their subsequent complications represent major causes of morbidity, hospitalization, and cost for chronic hemodialysis patients. Aim of the study: The main objective of this study is to identify risk factors for failure of autogenous arteriovenous fzstulae which had successfully matured and were used for dialysis in hemodialysis patients. Patients and methods: Sixty selected cases of chronic renal failure patients who were referred for AVF during March 2006 to April 2008 were operated on to create AVF and followed up for two years. Results: There were a total of76 autogenous AVF performed for 60 patients. 32 (53.3%) of the procedures were distal fistulae, followed by 25 (41.7%) cubital fossa fistulae (proximal fistulae) and other sites fistulae were only 3 (5%). Hypertension was present in 24 (40%) of the patients, and diabetes was present in 11 (18.3%). 12 (20%) of the studied cases were overweight. HCV was found in 28 (46.7%) of the patients. 21 (35%) of patients had past history of fistula failure during their course of renal dialysis. Patients who developed AVF failure had significantly lower hemoglobin levels and were more likely to have previous fistula failure. Conclusion: Predictors of AV-fistula malfunction in our dialysis population were lower hemoglobin levels and previous fistula failure.