Document Detail

Complications of arteriovenous fistula in dialysis patients.
MedLine Citation:
PMID:  16797276     Owner:  NLM     Status:  MEDLINE    
Repeated access to the circulation is essential to perform adequate maintenance hemodialysis (HD). Dysfunction of fistulae is the most common reason for a second intervention and recurrent hospitalization. The aim of this study was to evaluate the complications of HD fistulas seeking to evaluate the impact of age, site of arteriovenous fistula (AVF) (proximal or distal), side (left or right), and history of previous vascular access. We evaluated the clinical complications in 273 patients from the beginning of the use of the current access using the history and physical examination obtained at every dialysis session. We performed further investigations including doppler ultrasound or spiral computed tomography to confirm the clinical diagnosis. Of our patients, 40% had diabetes mellitus as the cause of end-stage renal disease. Almost half (49%) the patients dialyzed through an AVF and 13% with a catheter. One hundred eighty-four cases (67.6%) experienced complications. Of 145 cases that had elbow AVFs, 103 cases (71%) had complications; of 128 cases with wrist AVFs, 80 cases (62.5%) had complications. There were 115 (62.5%) complicated cases among 185 patients with left AVFs, and 69 (78%) among 88 patients with right AVFs. The rate of AVF complications increased with age. The 1-year survival rate was 94%. We did not observe any significant difference between AVF complications in patients with diabetes mellitus or hypertension as the underlying cause of renal failure. Mean cholesterol plasma level did not differ significantly between the patients with and without AVF complications. Mean hematocrit levels were not significantly different between the two groups. However, mean EPO weekly dose was significantly higher among the group of patients with AVF complications. We did find that rate of complications increased with age (P<.05). Our results showed that the frequency of complications was higher among patients with elbow and right-side AVFs, and also among patients with a history of a previous failed shunt but no significant relationship was observed between these variables (P>.05).
H Salahi; A Fazelzadeh; A Mehdizadeh; A Razmkon; S-A Malek-Hosseini
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Transplantation proceedings     Volume:  38     ISSN:  0041-1345     ISO Abbreviation:  Transplant. Proc.     Publication Date:  2006 Jun 
Date Detail:
Created Date:  2006-06-26     Completed Date:  2006-08-22     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0243532     Medline TA:  Transplant Proc     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1261-4     Citation Subset:  IM    
Southern Iran Organ Transplant Center, Fars, Iran.
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MeSH Terms
Arteriovenous Fistula / epidemiology*,  etiology
Erythropoietin / therapeutic use
Functional Laterality
Middle Aged
Renal Dialysis / adverse effects*
Retrospective Studies
Risk Factors
Vascular Diseases / epidemiology
Reg. No./Substance:

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