A multicentre analysis of the outcome of arteriovenous fistula in maintenance haemodialysis

Abstract

Introduction: Arteriovenous fistulas (AVF) are the preferred choice for vascular access in hemodialysis. We aim to identify factors that may contribute to AVF failure. Methods: Data regarding AVF survival were collected from 441 patients. All AVFs were either radial or brachial, of the end‐to‐side variety. Parameters studied were age, gender, diabetes mellitus, hypertension prior to end‐stage kidney disease (ESKD), site of fistula, blood flow rate, venous pressure, dialysis vintage and frequency, needle gauge used during dialysis, year of fistula creation, and details of fistula failure. Findings: The 6‐month, 1‐year and 2‐year AVF survival rates were 98.41%, 95.01%, and 89.57%. Failure rates were 17.2%, 5.5%, 26.8%, and 14.4% for dominant radial, non‐dominant radial, dominant brachial and non‐dominant brachial respectively (P < 0.001). Using a larger needle size had better AVF survival rate (P < 0.05). All other factors had no significant correlation with AVF failure. Conclusion: There were no statistically significant differences in AVF patency with respect to gender, age, blood flow rate, presence of diabetes mellitus or systemic hypertension. A distally placed AVF in the nondominant arm had the best survival rate. Using a larger needle size, specifically 15G during dialysis, was associated with lowest AVF failure.

Deep Learning‐Based Digital Subtraction Angiography Characteristics in Nursing of Maintenance Hemodialysis Patients

“…MHD access is the lifeline of treatment for patients with endstage renal disease, but it is easy to have narrow and blocked vascular access during treatment, resulting in significantly reduced hemodialysis flow, seriously affecting the final therapeutic effect and prognosis of patients [18][19][20]. Balloon dilatation of AVFs, as the treatment of choice for MHD, is widely used in clinical practice because of its characteristics of less susceptibility to infection and a long duration of patency [21][22][23].…”

The reasons for comparative effectiveness clinical trials of arteriovenous fistula versus graft strategy in older adults on hemodialysis with a catheter

“…Nevertheless, some observational studies continue to report AVF maturation rates in older adults that are similar to the profile of AVF development in younger counterparts [ 34 ]. Other studies suggested no significant difference in AVF maturation and survival rates by age, sex, and presence of diabetes mellitus [ 35 ]. Clinical trials that analyze access-related outcomes following AVF vs. AVG creation in a highly pertinent context, i.e., older adults with comorbidities linked with AVF failure, would meet the goal of providing information for patient-tailored clinical decision.…”

6. Đánh Giá Kết Quả Phẫu Thuật (Theo Quy Trình Rút Gọn) Cầu Nối Động - Tĩnh Mạch Dùng Chạy Thận Tại Bệnh Viện Thống Nhất

“…Trong đó: n: Cỡ mẫu nghiên cứu cần có; P: Tỷ lệ mẫu ước tính; α: Mức ý nghĩa thống kê thường là 0.05; d: Khoảng sai lệch mong muốn giữa tham số mẫu và tham số quần thể; Z(1-α/2): Giá trị Z thu được tương ứng với mức ý nghĩa thống kê mong muốn. Với tiêu chí đánh giá hiệu quả phẫu thuật qua biến chứng (nếu có), dựa vào một số nghiên cứu tương tự như Nguyễn T.Quyên(2017) [2], Sa M.Dương (2019) [3], Nguyễn Đ.Nhân(2023) [4] biến chứng cầu nối trong khoảng 5-20%, chúng tôi chọn p = 0,1, d = 0,1. Thế vào công thức, được n = 34,57.…”

“…Tuy nhiên, có thể gặp kích thước mạch trên siêu âm và phẫu thuật khác nhau. Một phân tích đa trung tâm cho thấy trước phẫu thuật đường kính động mạch >2mm, tĩnh mạch >2,5mm, miệng nối phẫu thuật > 04mm tỷ lệ thành công cao hơn hẳn [4].…”