Abstract

Objective:
To evaluate the clinical characteristics and failure rate of arteriovenous fistula (AVF) among patients undergoing haemodialysis with end-stage renal disease.
Study Design:
Cross-sectional study.
Place & Duration of Study:
Department of Urology, Asian Institute of Medical Sciences,Hyderabad, Pakistan, from January 2023 to June 2023.
Methodology:
The study included 161 patients over 20 years old with end-stage renal disease undergoing haemodialysis. Exclusion criteria were severe comorbidities, ICU admission, loss to follow-up, and unwillingness to participate. Data were collected on demographics, medical history, and clinical examinations. AVF creation sites were selected based on blood pressure measurements and the Allen test. The procedure involved assessing vascular diameter, intravascular thrombosis, arterial wall atherosclerosis, and patency of arterial inflow and venous outflow. AVFs were created using end-to-side or side-to-side techniques. Fistula patency was assessed on the first day, the first week, and during haemodialysis after the sixth week. Data were analyzed using SPSS version 26.
Results:
The majority of patients were over 50 years old (49.07%), with 70.19% males. Obesity was prevalent in 29.81%, and 26.09% were overweight. Diabetes mellitus (32.92%) and hypertension (29.19%) were common comorbidities. The leading cause of ESRD was diabetes/hypertension (55.28%). AVFs were most commonly created at the left brachiocephalic site (39.13%) and left radiocephalic site (31.06%). At two-month follow-up, 90.68% of AVFs were functional, 3.11% failed, and 4.97% burst. The primary patency rate was 67.70%, and the secondary patency rate was 32.30%. Complications included infections (33.33%), thrombosis (20.83%), and stenosis (12.50%). Hospitalization due to AVF-related issues occurred in 33.33% of patients.
Conclusion:
AVFs in haemodialysis patients with end-stage renal disease show high functionality but significant complication rates. Continuous monitoring and early intervention are essential to improve outcomes.

Key words: Arteriovenous fistula, hemodialysis, end-stage renal disease, patency rate, complications.