ABSTRACT

Aim:

To determine survival of permanent vascular access routes (arteriovenous fistula [AVF], arteriovenous graft [AVG] and permanent catheter) in patients scheduled for hemodialysis with a diagnosis of chronic kidney disease (CKD) and in whom permanent vascular access is established, and to identify factors affecting those survival rates, thus contributing to prolongation of survival of subsequent permanent vascular access routes pathways.

Materials and Methods:

420 patients under monitoring with a diagnosis of CKD at the KTU Nephrology Clinic receiving AVF, AVG or permanent catheter for the purpose of establishing permanent hemodialysis access by surgeons from the KTU Medical Faculty Thoracic and Cardiovascular Surgery Department aged 18 or over and whose files were available from the archives were included in the study. Patients’ biochemical, hematological and demographic data were recorded. The effect of these parameters on vascular access survival was then analyzed.

Results:

AVF was applied in 86% of the 420 CKD cases in this study, AVG in 10.5% and permanent catheter in 9.8%. Mean AVF patensi was 34.73 months, mean AVG survival 27.59 months and mean permanent catheter survival 8.53 months. Vascular access survival was affected by age, a history of central venous catheterization before establishment of vascular access, time of first use of vascular access and upper extremity arterial and venous Doppler USG examination before surgery.

Conclusion:

The patient’s age, history of central venous catheter use and waiting time for fistula and graft maturation are important in terms of prolonging survival of permanent vascular access routes. Central venous catheterization should be avoided in patients scheduled for permanent vascular access for hemodialysis, and it is important to wait for AVF-AVG maturation before cannulation.