演題情報

学会・委員会企画

開催回
第56回・2011年・横浜
 

Evaluation of Arterio-Venous Fistula Patency One Year Follow-up Study in Patients on Maintenance Haemodialysis

演題番号 : GI-9-3-4

Kazi S. Alam:1、Manash Saha:1、Firoz Khan:1、Waliul Islam:1

1:National Institute of Kidney Disease and Urology

 

【Background】 Areterio-venous fistula(AVF) is life-line for maintenance haemodialysis patients. This cross sectional, observational study was carried out to explore areterio-venous fistula patency after one year of creation in patients of maintenance haemodialysis (MHD).  【Materials and Method】 118 ESRD patients (CKD-V) on MHD in National Institute of Kidney Diseases & Urology, Dhaka was evaluated. Only 20 patients underwent preoperative assessment by Duplex scan.  【Results】 Out of 118 patients 80 were male and 38 female with age ranged from 26 to 72 years. Predominant primary disease causing ESRD was Glomerulunephritis (53, 44.9%) followed by diabetes (44, 37.2%) and hypertension (15, 12.7%). 101 patients had radio-cephalic and 17 patients had brachio-cephalic fistula. 112 (94.9%) ESRD patients started haemodialysis through temporary vascular access, (either Femoral or Jugular catheter) for a variable period of 2-4 months before AVF was created. We found primary fistula failure in 11 patients (9.32%) which were mostly due to lack of proper pre-operative evaluation. 6 (5.0%) patients expired due to complication of CKD and 8 patients dropped out. Out of remaining 90 patients, AVF maintained patency in 83 (92.2%) patients. 7 (7.77%) developed secondary fistula failure, (3 due to blood clot, 4 due to infection and 2 due to aneurysm and rupture) all of which required second time AVF creation.  【Conclusion】 Primary and secondary arterio-venous fistula failure should be minimized by proper pre and post-operative management and development of surgical skills.

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