Practice Pattern of Hemodialysis Vascular Access in Maiduguri, Nigeria

Abstract

Despite available evidence based recommendations and guidelines there are differences in the preferred type of vascular access in use in different localities and geographical regions. This one center study on the practice pattern of vascular access was carried out in Maiduguri, Nigeria covering a period of the first 5 years of renal care in the area. We analysed the dialysis and hospital records of consecutive patients that received hemodialysis in the renal center during the period between January 2000 and December 2004. Data comprised patients' demographics, vascular access used, complications encountered during the treatment period. Clinical and laboratory features of the patients were also recorded and analysed. The study involved one hundred and seventy-nine patients (M:F=2:1) who suffered kidney failure whose cause was clinically determined to be mainly due to chronic glomerulonephritis, hypertension, obstructive nephropathy and interstitial nephritis. Majority presented as late referrals to the nephrologist. Overall 9% of the study population used AVFs while 91% used catheters inserted into the femoral or internal jugular veins. The use of catheters for vascular access was the practice in the majority of the patients and this is possibly related to the poor survival of the patients on hemodialysis. Socioeconomic circumstances of the patients in turn largely influenced the rate of AVF use.