A retrospective study of haemodialysis fistulae

Abstract

Background There are no large Norwegian studies reporting the outcome of AV-fistulae made for haemodialysis. We wanted to evaluate our work, and investigate the patency of arteriovenous fistulae created at a central hospital in Norway.

Material and Methods A retrospective study of 73 primary AV-fistulae (18 females, 55 males), created between 20.07.90-10.10.01 at Central Hospital of Rogaland. Median age was 67.9 years (range 22.6-86.3). 62% had a relevant vascular disease, 11% had diabetes, and 37% had none of these diseases.

Results Time from access creation until first dialysis was median 5.9 weeks (range 2.7-105.0). 12 fistulae were being used within 4 weeks after access creation, 58% of these needed interventions, all due to occlusion. Of the 53 fistula were time from access creation until first dialysis was more than 4 weeks, 32% needed interventions. The majority of first time interventions were carried out within one year subsequent to access creation. A total of 40% of the fistulae needed interventions, of which 55% became functional. At first intervention, 16 presented with occlusions, 7 with stenosis and 4 with bleedings/aneurysms. Interventions were thrombectomy (9), new anastomosis (6), patch (3), other surgery (7) and PTA (4). Time-interval between access creation and first intervention was median 16.7 weeks (0-159.3).

Conclusions We find that time of maturation should be at least 4 weeks. The majority of complications occur within one year of access creation. Occlusion was the grounds for intervention in over 50% of cases. Functionality was re-established in 55 % of the fistulae with complications. This indicates that interventions are beneficial.