The arteriovenous fistula (AVF) is the vascular access of the first choice for hemodialysis (HD). Studies on patency of AVF and its affecting factors reveal a high risk for access failure. The aim of this study was to assess the primary and secondary AVF patency and their determinant factors. It was a retrospective, descriptive study conducted in the HD facility of the Nephrology Department in Rabta University Hospital. We included AVF created before December 2009 in end-stage renal disease (ESRD) patients. The end of the follow-up was fixed in December 2013. We included 126 AVFs created in 111 patients; 22.5% were aged >65 years, 39.6% were diabetic, 68.5% were hypertensive, and 26.1% had peripheral vascular disease. The primary patency rates were 78% at one year and 42% at five years. The secondary patency rates were 80% at one year and 69% at five years. Multivariate analysis revealed that the factors affecting the primary patency of AVF were: the use of jugular catheter for longer than three months (odds ratio (OR):1.91, P = 0.044) and a C-reactive protein >5 mg/L (OR: 1.7, P = 0.049). Aging (>65 years) (OR: 2.46, P = 0.042), referral time to a nephrologist <6 months before onset of ESRD (OR: 2.87, P = 0.015), absence of an antiplatelet therapy (OR: 4.47, P = 0.005), and serum phosphorus <45 mg/L (OR: 2.07, P = 0.045) were the significant impairing risk factors for secondary AVF patency. Our study suggests that early referral and creation of AVF and maturation before ESRD as well as its adequate monitoring are essential for maintaining patency.

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Background: Methoxy polyethylene glycol-Epoetin beta (M.PG.E-β) is a long-acting erythropoietin receptor activator treatment indicated for the treatment of patients with anemia associated with end stage renal disease (E.S.R.D). It is the first approved chemically modified erythropoiesis-stimulating agent (E.S.A). Hypermagnesemia is one of the common complications accompanied with E.S.R.D patients submitted to hemodialysis. It progresses early in the course of the disease and increases its rate with the declination in renal efficacy. Objective: This study targeted to determine the influence of M.PG.E-β therapy on serum Mg+2 levels in patients with E.S.R.D. Patients and Methods: In this study , seventy patients with E.S.R.D on hemodialysis receiving M.PG.E-β and twenty healthy subjects without medical illnesses were included in this case-control cross sectional study. Results: Patients had significantly higher serum Mg+2 level at the baseline (p<0.01) compared to the healthy control group because of loss of renal function in these patients. M.PG.E-β dose was then given three months after the baseline dose and showed a significant decline in serum Mg+2 levels (p<0.05) in patients with E.S.R.D during the study. Conclusion: It can be concluded that relative elevation of serum Mg+2 was linked with E.S.R.D patients and the administration of M.PG.E-β usually leads to a significant subside in its levels.

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