The vascular access questionnaire: a single centre UK experience

Abstract

Background Haemodialysis is capable of prolonging life in patients with end stage renal disease, however this therapy comes with significant negative impact on quality of life. For patients requiring haemodialysis, the need for an adequately functioning vascular access (VA) is an everyday concern. The Vascular Access Questionnaire (VAQ) provides a mechanism for identifying and scoring factors in haemodialysis that impact on patients’ quality of life and perception of their therapy. Methods Between April 2017–18 the VAQ was administered to prevalent haemodialysis patients at 10 units in the West Midlands via structured interviews. Results 749 of 920 potentially eligible patients completed the survey. The mean VAQ score was seen to improve significantly with age (7.7 in < 55 vs. 3.8 in 75+) and the duration of access (8.9 if less than 1 month old vs. 5.0 at a year). Better average scores were demonstrated for Arteriovenous fistulas (AVF) than other modalities (AVF 5.1 vs. AVG (arteriovenous grafts) 7.2 vs. CVC (central venous catheter) 6.6). There was no significant difference in scores between fistulas on non-dominant or dominant arms, with both having a mean of 5.2 ( p = 0.341). Conclusions Overall, better satisfaction scores were seen in AVF. The presence of an AVF on the non-dominant arm was not a concern for the majority of patients and did not affect the VAQ score. A number of factors were identified that can influence VAQ satisfaction score. Electronic supplementary material The online version of this article (10.1186/s12882-019-1493-9) contains supplementary material, which is available to authorized users.

The attitude of kidney transplant recipients towards elective arteriovenous fistula ligation

“…Some studies also suggest that the localization of AVF in hemodialyzed patients may be associated with symptoms severity, which in turn influences the QOL [ 24 ]. These observations, however, were made in a cohort of dialyzed patients and it remains unclear whether they can be extrapolated from KTRs with persistent AVF.…”

Validation of a vascular access specific quality of life measure (VASQoL)

“…To detect significant differences in the temporal changes of quality of life in relation to vascular access events, we estimated a priori that at least 30% of the cohort would experience an access related event. Previous work utilising the VAQ measure identified a 25% event rate for radiological procedures alone in the preceding year 30 . The sample size required for factor analysis in Phase 3 was determined by calculating a subject to item ratio of the VASQoL questionnaire (11 items) of 9:1 31 .…”

Effect of Buffered Local Anesthesia on Perioperative Pain During Arteriovenous Fistula Surgery: A Randomized Control Trial

“…The Kidney Disease Outcomes Quality Initiative (KDOQI) guidelines have emphasized the arteriovenous fistula as the first initiative because of its superior patency, lower complication rate, and lower healthcare expense [3]. However, there are several obstacles to this practice including delayed referrals to doctors, patient noncompliance with surgical procedures, and patient comorbidities [4].…”

“…Most vascular surgeons tend to operate under local anesthesia due to the complications and risks involved with other types of anesthesia in such patients. According to Filed et al, 73.9 % of respondents thought AVF was better for their health, but they were hesitant to undergo surgery for a variety of reasons, the most common of which was pain during surgery [4]. Pain from lignocaine injections is influenced by surgical experience, needle gauge, rate and volume of infiltration, temperature, and most importantly, the acidic pH of the solution [5].…”