Clinical profile and early outcome of arteriovenous fistula creation for Haemodialysis: Integrated activity in a general surgery unit
AbstractIntroduction: A functioning arteriovenous fistula (AVF) is essential for maintenance hemodialysis (HD) in a patient with chronic renal failure. This study explores the creation of AVF as an integral activity in a general surgical unit by a general surgeon.
Methods: This is a hospital based cross sectional study done at Patan Hospital patients who underwent creation of AVF from January 2015 to June 2015 were included in the study. Patient demographic and clinical data were documented. Outcome and complications of AVF surgery were obtained over a 6 months period from the time of vascular access creation.
Results: Thirty-seven patients were operated in the study period with a mean age of 35.44 years and M: F ratio of 2.7:1. There were 3 immediate and 3 delayed failure with 81.81% (n=27) patency rate at 6 months follow up. The maturation time was 3-7weeks (mean +/- SD of 4.83 +/- 1.053). Complication occurred in 4 patients, namely arm edema (n=3) and haematoma (n=1).
Conclusion: The creation of AVF for HD performed in a general surgery unit is a safe procedure with satisfactory outcome and acceptable level of complications.
2. Dilege S, Baktiroglu S, Basar Y, Genc FA, Ozgur F. Basilic vein transposition as vascular access for hemodialysis. Turkish J Thorac Cardiovasc. 1995;3:140-142.
3. Pisoni RL, Young EW, Dykstra DM, etal. Vascular access use in Europe and the United States: results from the DOPPS. Kidney Int. 2002;61(1):305-316.
4. Dhingra RK, Young EW, Hulbert- Shearon TE, Leavey SF, Port FK. Type of vascular access and mortality in U.S. hemodialysis patients. Kidney Int. 2001;60(4):1443-1451.
5. McGrogan DG, Maxwell AP, Inston NG, Krishna H, Field H. Preserving Arteriovenous fistula outcomes during surgical training. J Vasc Access. 2014;15(6):474-480.
6. Hirth RA, Turenne MN, Woods JD, Young EW, Port FK, Pualy MV. Predictors of type of vascular access in hemodialysis patients. JAMA. 1996;276(16):1303-8.7. Allon M, Daurgidas J, Depner TA, Greene T, Ornt D, Schwab SJ. Effect of change in vascular access on patient mortality in hemodialysis patients. Am J Kidney Dis. 2006;47(3):469-477
8. Clinical practice guidelines for vascular access: update2000. Am J Kidney Dis. 2001;37(1 Suppl 1):137-81.
9. Ahmed GM, Mansor MO, Elfaith M, Khalid KE, Ahmed ME. Outcomes of arteriovenous fistula for hemodialysis in Sudanese patients: Single-Centre experience. Saudi Journal of Kidney Disease and transplantation. 2012;23(1):152-157.
10. Bakari AA, Nwankwo EA, Yahaya SJ, Mubi BM, Tahir BM. Initial five years of arteriovenous fistula creation for hemodialysis vascular access in Maiduguri, Nigeria. Int J Cardiovasc Res. 2007;4(2):1-6.
11. Alhassan SU, Adamu B, Abdu A, Aji SA. Outcomes and complications of permanent hemodialysis vascular access in Nigerians: A single centre experience. Ann Of Afr Med. 2013;12(2):127-130.
12. Di lorio BR, Bellizzi V, Cilio N etal. Vascular access for haemodialysis: the impact on morbidity and mortality. J Nephrol. 2004;17(1):19-25
13. Fitzgerald JT, Schanzer A, Chin AL, McVicar JP, Perez RV, Troppmann C. Outcomes of upper arm arteriovenous fistulas for maintenance hemodialysis access. Arch Surg. 2004;139(2):201-8
14. Rooijens PP, TOrdoir JH, Stijnen T, Burgmans JP. Radiocephalic wrist arteriovenous fistula for hemodialysis: Metaanalysis indicates a high primary failure rate. Eur J Vasc Endovasc Surg. 2004;28:583-9
15. Malovrh M. Native arteriovenous fistula: pre-operative evaluation. Am J Kidney Dis. 2002;39(6):1218-25.
16. Iyem H. Early follow up results of arteriovenous fistulae created for hemodialysis. Vascular Health and Risk Management. 2011;7;321-325.17. Almonacid PJ etal. Ambulatory surgery of patients with arteriovenous fistulas for hemodialysis. Intregrated activity in a department of general surgery. Nefrologia. 2010;30(4):452-7
18. Turkish society of Nephrology. Registry of the Nephrology, Dialysis and Transplantation in Turkey. Registry 2004. Omega CRO. Istanbul, Turkey: Turkish Society of Nephrology;2005.
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