Abstract Background:  Due to the long waiting time for kidney transplantation, most End-Stage renal disease patients are commenced on either hemodialysis or peritoneal dialysis. Reusable fistulas have the lowest risk for death, cardiovascular events, and infections among all vascular accesses. This study aims to report the outcomes of the arteriovenous fistulas and PTFE grafts and the related predictive clinical and demographic variables. Methods:  This retrospective study reviewed the charts of all hemodialysis patients between January 2017 and January 2021 at the Dialysis Center of An-Najah National University Hospital, Nablus, Palestine. Our outcomes were a primary failure,  primary  and  secondary  patency,  and  the  related  factors.  Survival  analysis  using  the  Kaplan-Meier  method  was conducted, and the log-rank test was used to compare patency rates. The Cox proportional hazards regression model tested factors relevant to primary and secondary patency rates in univariate and multivariate analyses. Results:  A total of 312 procedures were performed during the study period. Primary failure was 7.1% for AVF, 13.9% for arterio-venous graft (AVG) procedures. Peripheral arterial disease and left-sided AVF were associated with more primary  failure  rates.  AVF, primary  patency  rates at  1, 2,  and 3 years  were 82%,  69%, and  59%, respectively,  while secondary patency rates at 1, 2, and 3 years were 85%, 72%, and 63%, respectively. Factors associated with increased AVF patency in a proportional hazard model were younger age and dual antiplatelet administration. Conclusion:  Our  study  adds  further  evidence  that  autogenous  AVF  has  better  results  than  prosthetic  AVG  in  both primary and secondary patency rates as well as less primary failure rates. Therefore, we encourage further longitudinal studies that assess the benefits of using antiplatelet on AVF outcome versus risks of bleeding, especially with dual agents.

Title

The Journal of Vascular Access

Publisher

An-Najah National University

Publisher Country

Palestine

Indexing

Scopus

Impact Factor

2.283

Publication Type

Prtinted only

Volume

10

Year

2021

Pages

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