Document Detail


Patients on Hemodialysis Are Better Served by a Proximal Arteriovenous Fistula for Long-Term Venous Access.
MedLine Citation:
PMID:  23064823     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Patients with end-stage renal disease should have arteriovenous fistula (AVF) formation 3 to 6 months prior to commencing hemodialysis (HD). However, this is not always possible with strained health care resources. We aim to compare autologous proximal AVF (PAVF) with distal AVF (DAVF) in patients already on HD. Primary end point is 4-year functional primary. Secondary end point is freedom from major adverse clinical events (MACEs). From January 2003 to June 2009, out of 495 AVF formations, 179 (36%) patients were already on HD. These patients had 200 AVF formations (49 DAVF vs 151 PAVF) in arms in which no previous fistula had been formed. No synthetic graft was used. Four-year primary functional patency significantly improved with PAVF (68.9% ± SD 8.8%) compared to DAVF (7.3% ± SD 4.9%; P < .0001). Five-year freedom from MACE was 85% with PAVF compared to 40% with DAVF (P < .005). Proximal AVF bestows long-term functional access with fewer complications compared to DAVF for patients already on HD.
Authors:
Sherif Sultan; Niamh Hynes; Nader Hamada; Wael Tawfick
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-10-12
Journal Detail:
Title:  Vascular and endovascular surgery     Volume:  -     ISSN:  1938-9116     ISO Abbreviation:  Vasc Endovascular Surg     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-10-15     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101136421     Medline TA:  Vasc Endovascular Surg     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
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