Outcomes of Hemodialysis Native Arteriovenous Fistula Creation in Iraq: A Combine Prospective and Retrospective Study

Abstract

Vascular access (VA) is a lifeline for end stage renal disease (ESRD). The native arteriovenous fistula (AVF) is the oldest and the best. The study aimed to assess the outcomes of hemodialysis native AVFs creation in Iraq. Fifty-six patients (33 males, and 23 females) with ESRD, and native AVF were studied over five months, from December 2014 till April 2015.Demographic and clinical features as well as co-morbidities were checked. Allen’stest used to assess palmer arch patency, and examination of upper limb superficial veins were performed. Brachiocephalic or radio cephalic AVFs were created mostly under local anesthesia. Complications were noted during a follow up period of 3 weeks to 5 months. The mean age was 49 year. AVFs (n=58) were mostly brachiocephalic (n=46,79%). Side-side anastomosis was used in 42(72.3%) of participants. Most of fistulae functioned primarily. The significant complications were thrombosis (n=9, 16%), distal edema (n=6, 10.3%) and aneurysm (n=3,5%). Eight surgical revisions were required, which were three seroma evacuations, three thrombectomies and two aneurysmectomy with vessel ligations. AVF initial success was good, but the late complications were high.