ABSTRACT
The rate of end stage renal disease [ESRD] has changed dramatically after innovation of hemodialysis in 1942. Introduction of arteriovenous fistula [AVF] made a new and comfortable vascular access, and since then function and complications of it became a matter of concern. In this study all hemodialysis patients in two referral hospitals [Imam Khomeini and Dr Shariati] were assessed for function and complications of their fistulas. In 108 patients with AVF, the average length of function was 3 years which was positively related to interval between surgery and beginning of dialysis via the fistula [P<0.03], and negatively related to history of dual catheter insertion [P<0.05] and diabetes mellitus [P<0.02]. The mean flow of fistulas was 245 ml/s. Most common complications were aneurysmal degeneration of fistula and venous site punctures which were related to length of using the fistula and diabetes [P<0.02].Among other complications,paresthesia, coldness of fingers and edema had a higher prevalence. Despite earlier convictions,proximal AVFS did not have markedly significant complications compared to distal fistulas. We concluded that after the diagnosis of ESRD is established, AVF operation should be done before the patient needs to central venous access for hemodialysis. Antecubital area can he used in patients with poor distal vessels without concern about more complication rate. Finally diabetes is an important and determining negative factor in both aspects function and complications