[Comparison of temporary dialysis catheter and A-V fistula use at the time of starting chronic hemodialysis among end-stage renal diseases patients]

ABSTRACT

The preferred type of access for chronic hemodialysis [HD] is an Arterio-Venous [A-V] Fistula. However most of the ESRD patients does not have a mature fistula at the time of starting HD due to late referral to the nephrologists so the managing physicians have to use temporary catheters with high rate of complications. In a retrospective study we determined and compared the prevalence of temporary catheters or A-VFistula use at the time of starting chronic HD from November 1995 to June 2009. We have divided our patients in three different groups. Group A HD patients between 1995-2005, Group B HD patients between 2006-2007, and Group C HD patients after 2007. A total of 473 ESRD patients [288 male, 185 female; mean age, 55.8 +/- 16.4 years] were included in the study. Causes of ESRD were HTN 34.1%, DM 20. 08%, glomeronephritis 9.72%, obstructive uropathy 8.46%, ADPKD 5.92%, and unknown 21.77%. Overall the prevalence of temporary catheters and A-V Fistula use were 86.5 and 13.5 percent. But the prevalence was different in the studied groups group A [93.6% and 6.4%], in group B [85.0% and 15.0%] and in group C [67.5% and 29. 5%] respectively. There was a significant increase in A-V Fistula use after 2005 [p=0.00] and especially after 2007 [p=0.000]. Although there was a significant increment in the A-V Fistula use, it is not still enough and general physicians, nurses and chronic kidney disease patients have to be educated about the benefits of early A-V Fistula creation