Vascular access for haemodialysis

ABSTRACT

The aim of this study was to report our results of vascular access surgery and the factors affecting the outcome. Descriptive study with prospective data. This study was carried out at the Combined Military Hospital Rawalpindi, the Military Hospital Rawalpindi and the Armed Forces Institute of Urology form January 1997 to July 2000. Patients with end stage renal disease needing chronic haemodialysis were included in the study. The operative technique used was relatively standard. The fistula initially sited was distal in the arm for as long as possible and in an easily accessible position. Patients who received renal transplant, discontinued dialysis with a functioning shunt and patients who died were excluded form the study. The primary cumulative at one year patency Cimino AV fistula, elbow AV fistula and graft AV fistula is 66%, 70% and 37% respectively. Diabetic patients had much lower patency than non- diabetics. A distal autogenous radio-cephalic fistula should be the first choice in patients requiring chronic haemodialysis. The elbow arterio-venous fistula should he the second choice before planning a prosthetic graft