A prospective study of arteriovenous fistula creation in chronic renal failure patients in Bhavnagar, Gujarat, western India
Journal Title: International Journal of Medical Science and Public Health - Year 2016, Vol 5, Issue 2
Abstract
Background: Arteriovenous (AV) fistula is an autogenous connection between an artery and a vein, which allows adequate blood flow during hemodialysis in patients with chronic renal failure, and they have superior patency rates and lower complication rates than grafts. Objective: To study the success rate of AV fistula, postoperative complications, and factors affecting the patency rate of AV fistula. Materials and Methods: This prospective study was conducted in Department of General Surgery of Sir Takhtsinhji Hospital, Bhavnagar, Gujarat, India, during 2012–2014 in patients of all age groups and both gender with chronic kidney disease. Result: Of the 150 patients enrolled in the study, 62% revealed radiocephalic fistulas while 17% brachiocubital fistulas. In majority of the patients (81%), side-to-side anastomosis was done, while in 19% patients, end-to-side anastomosis was done. The AV fistula remained patent in 115 (77%) patients, and among them, the patency rate of radiocephalic was 60% and that of brachiocephalic was 13%. The patency rate for side-to-side fistula was 83% and that for end-to-side was 18%. Patency rate for patients with hemoglobin (Hb) > 9 g % was 94% with only 6% for patients with Hb < 9 g %. Nonsmokers were 3.6 times (95% CI: 1.58–8.23) more likely to have their fistula patent than smokers. Arterial diameter is also a predictor of patency. Conclusion : The success rate of AV fistula by conventional vascular anastomosis technique was 77%. Side-to-side anastomosis showed better patency rate than end-to-side anastomosis. Radiocephalic AV fistula showed better patency rate than other types of fistulas performed in upper limb. Anemia (Hb < 9 g %), smoking, and arterial diameter were the major factors affecting fistula patency. Thrombosis, postoperative edema, surgical site infection, steal phenomenon, and aneurysm were the complications noted in the postoperative period.
Authors and Affiliations
Firdaus A Dekhaiya, Tejas N Hathila, Shrut A Doshi, Nirav B Mehta, Samir M Shah, Mihir P Rupani
Keywords
Related Articles
- EP ID EP148935
- DOI 10.5455/ijmsph.2016.1507201543
- Views 83
- Downloads 0
Comparing lipid profile in healthy participants with and without smoking: A prospective study
Background: Smoking can induce cancer, stroke, and heart disease and also has been reported to cause periodontal disease, gastric ulcer, sudden infant death syndrome, and metabolic syndrome. Objectives:...
Gender power dynamics in rural area of India
Background: There is a growing concern with the issues of women’s empowerment and individual rights. It has been recognized that the absence of an equal status of women is clearly linked to denial of their reproductive r...
Prevalence and health-care seeking behavior of chest symptomatic among children in Udupi, Karnataka
Background: Globally, the burden of tuberculosis is estimated to be highest in India. As per Revised National Tuberculosis Control Program (RNTCP) India 2011 Report, 44,357 smear-positive cases were diagnosed amon...
Nutritional status of under-5 children in the newly carved states of India
Background: In June 2014, state of Andhra Pradesh was divided into two new states of Telangana and Andhra Pradesh. Both the new states will face the challenges of new born states in the coming years. India’s progress...
Comparative evaluation of moderate dose inhalational corticosteroid (ICS) fluticasone with the combination of low dose fluticasone and montelukast in moderate persistent bronchial asthma
Background: Use of inhaled corticosteroids (ICS) are recommended in all grades of persistent asthma and once the symptoms are stabilized, “stepping down" of steroids is recommended to minimize their unwanted effec...