The role of antiplatelet therapy on arteriovenous fistula malfunctioning among hemodialysis patients

Abstract

Background and objectives: The vascular access of choice for hemodialysis is the Arteriovenous fistula. A functional vascular access is required for a successful hemodialysis performance. The aim of the study is to examine the effect of antiplatelet therapy on arteriovenous fistula malfunctioning among hemodialysis patients. Methods: A cross-sectional study on 78 end-stage renal disease patients who undergone hemodialysis and had arteriovenous fistula was conducted. The data were collected during the period of 1st April 2020 to 1st April 2021, taking information about socio-demographic data of the patients such as age, gender, past medical history and hemodialysis status. Results: The mean age of patients was 63.87 (± 8.44) years; most of them were female and smokers. Only 17.9% of the patients were not on erythropoietin, while the rest were taking 8000 IU/week (55.1%) or 4000 IU/week (26.9%). After one year of having arteriovenous fistula, more than half (52.6%) of the patients developed arteriovenous fistula malfunctioning in the form of stenosis (17.95%) or thrombosis (34.62%). There were significant statistical associations between arteriovenous fistula malfunctioning and comorbidities, type of anti-platelet and use of erythropoietin. However, non-significant statistical association was found between the development of arteriovenous fistula malfunctioning and gender, duration of hemodialysis and smoking. Conclusions: Antiplatelet therapy and lower doses of erythropoietin use is associated with lower arteriovenous fistula malfunctioning. Prior to the arteriovenous fistula creation, patients should be assessed appropriately.