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British Journal of Medicine and Medical Research, ISSN: 2231-0614,Vol.: 2, Issue.: 1 (January-March)


Outcomes of Secondary Compared to Primary Autogenous Haemodialysis Arteriovenous Fistulae, a Five Year Survey


Khalid Bel’eed-Akkari1, Paul Renwick2, David Eadington3, Alan Webb3 and Sunil Bhandari3*

1Department of Renal Medicine, King Fahad Specialist Hospital, Dammam, Saudi Arabia.
2Department of Renal Medicine and Department of Vascular Surgery, United Kingdom.
3Hull and East Yorkshire Hospitals NHS Trust and Hull York Medical School, Kingston upon Hull, HU32JZ, United Kingdom.


Aims: We examined the outcome and patency rates of secondary in comparison to primary arteriovenous fistulae (AVF) in a cohort of haemodialysis (HD) patients.
Study design: A retrospective review of native AVFs formed in a five year period.
Place and Duration of Study: Department of Renal and Vascular Medicine Hull and East Yorkshire Hospitals NHS Trust, East Yorkshire between December 2000 to December 2005.
Methodology: HD patients who had autogenous AVF created in a single centre over a 5 year period. 346 patients (mean age 61±16 years, 35.8% females, 29.2% diabetics) were included. Data on type of AVF, demographics, co-morbidities, immediate outcome and subsequent vascular access (VA) patency were collected.
Results: 463 AVF were created (304 radiocephalic (RC) and 159 brachiocephalic (BC)), of which 160 (34.6%) were secondary procedures. There was no significant difference in the primary failure rate (PFR) of primary and secondary AVFs (38.9 vs. 37.5% respectively). Primary RC fistulae had a higher failure rate in comparison to BC fistulae (42.6 and 21.3%, respectively, p = 0.002, OR 2.7; CI: 1.4-5.3). There was a higher PFR of AVF among females (primary access: 47 vs. 33% in males, p = 0.028; OR 1.7; 95% CI: 1.1-2.8; secondary access: 53 vs. 27%, p= 0.002; OR 3.1; 95% CI: 1.5-6). There was no difference in PFR of primary and secondary fistulae among diabetics and non-diabetics.
Conclusion: The primary success rate of secondary autogenous AVFs is similar to primary fistulae. Females have a higher rate of fistula failure.

Keywords :

Arteriovenous; brachiocephalic; fistula; haemodialysis; radiocephalic.

Full Article - PDF    Page 62-73

DOI : 10.9734/BJMMR/2012/780

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