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Volume 22 |
October - December 2006 |
Number 4 |
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Published by : PROFESSIONAL MEDICAL PUBLICATIONS |
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Volume 22 |
October - December 2006 |
Number 4 |
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Factors Responsible for Fistula
Failure in Hemodialysis patients
Abdol Hassan Talaiezadeh1, Shahnam Askarpour2, F. Paziar3
Abstract
Introduction: There are multiple factors in failure of Arterio Venous Fistula (AVF) in patients with Chronic Renal Failure (CRF) that require periodic hemodialysis. Out of technical errors, hypotension, site of insertion, size of vessels, diabetes & atherosclerosis are the common causes of failure in AVFs. In this study failure of 100 AVFs in 70 patients was evaluated during four years.
Methods: Seventy five cases of CRF patients who were referred for AVF during January 1996 to December 2000 (1375-1379) were selected and operated upon AVF by a given surgeon with the same technique (end-to-side) and followed for two years regularly. In addition to underlying disease such as diabetes mellitus, atherosclerosis and inappropriate vessels another factors such as hypotension and bleeding of aneurismal vessels were recorded when AVF failed.
Results: Five out of 75 patients were excluded from this study because of impossible insertion of AVF due to severe damage and thrombosis of peripheral vessels. One hundred AVFs were inserted in 70 patients, 53 in snuff box of left hand, 26 in distal of left forearm, 17 cases in left arm and 4 ones in snuff box of right hand. Thirty percent failed primarily (before dialysis) commonly due to drop in blood pressure and among the remaining 70%, 47 patients had functional AVF for at least 20 months and 23 of them 7.5 months functioned for then failed monthly due to hypotension during hemodialysis. (p=0.006)
Conclusion: Hypotension was the cardinal cause of failure of AVFs in CRF patients. We can reduce failure rate of AVFs by monitoring and controlling the blood pressure during hemodialysis and prevent hypotension by salted regimen intake.
KEY WORDS: Arteriovenous fistula, Hemodialysis, Vascular access.
Pak J Med Sci October - December 2006 Vol. 22 No. 4 451-453
1. Dr. Abdol Hassan Talaiezadeh
2. Dr. Shahnam Askarpour
3. Dr. F. Paziar
1-3: Department of Surgery,
Imam Khomeini Hospital, Azadegan Avenue,
Ahwaz, IRAN
Correspondence:
Dr. Shahnam Askarpour
E-Mail:
shahnam_askarpour@yahoo.com
* Received for Publication: September 5, 2005
*
Accepted: April 30, 2006HOME | SEARCH | CURRENT ISSUE | PAST ISSUES
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