Etiology of arteriovenous fistula failure in hemodialysis patients

AUTHORS

Abdolhassan Talaiezadeh 1 , * , Shahnam Askarpour 1 , Faramarz Pazyar 1

AUTHORS INFORMATION

1 Assistant Professor, Department of Surgery, Ahwaz University of Medical Sciences, Ahwaz, Iran.

ARTICLE INFORMATION

Hormozgan Medical Journal: 9 (3); e90379
Published Online: July 16, 2005
Article Type: Research Article
Received: April 05, 2005
Accepted: July 16, 2005

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Abstract

Introduction: There are multiple factors in failure of arteriovenous fistula (AVF)
in patients with chronic renal failure (CRF) who require periodic hemodialysis.
Out of technical errors, hypertension, site of insertion, size of vessels, diabetes
and atherosclerosis are the common causes of failure in AVFs. This study is
designed to evaluate failure of AVF in patients.
Methods: In this descriptive study, 100 fistulas from 75 cases of CRF patients
who were referred for AVF during 1996-2000 were selected and operated upon
AVF by a given surgeon with the same technique (end-to-side) and followed 2
years relatively. In addition to underlying disease such as diabetes mellitus,
atherosclerosis and inappropriate vessels, other factors as hypotension and
bleeding of aneurismal vessels were recorded when AVF failed. The results were
reported using descriptive statistics.
Results: 100 AVFs were inserted in 70 patients, 53 in snuff box of left hand, 26
in distal of left forearm, 17 cases in left arm and 4 ones in snuff box of right
hand. 30% failed primarily (before dialysis) commonly due to drop in blood
pressure and among next 70%, 47 patients had functional AVF for at least 20
months and 23 of them had 7.5 months function who then failed commonly due
to hypotension during hemodialysis
Conclusion: According to this study, hypotension was the cardinal cause of
failure of AVFs in CRF patients. So we can reduce failure rate of AVFs by
monitoring and controlling the blood pressure during hemodialysis and prevent
hypotension by salted regimen intake.

Keywords

Arteriovenous fistula – Hemodialysis – Kidney Failure Chronic

© 2005, Hormozgan Medical Journal. This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/) which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited.
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