Comparison of Complications of Arteriovenous Fistula with Permanent Catheter in Hemodialysis Patients: A Six-month Follow-up

Document Type : Original Article

Authors

1 Division of Nephrology, Department of Internal Medicine, Shahrekord University of Medical Sciences, Shahrekord, Iran

2 Department of Internal Medicine, Shahrekord University of Medical Sciences, Shahrekord, Iran

3 Department of Epidemiology and Biostatistics, Social Health Determinants Research Center, School of Health, Shahrekord University of Medical Sciences, Shahrekord, Iran

Abstract

Background: Arteriovenous fistula (AVF), permanent catheter (PC), and vascular graft are three vascular access types used for hemodialysis procedure. Due to insufficient reliable information on the comparison between AVF and PC, this study was conducted to compare AVF and PC regarding dialysis adequacy. Materials and Methods: This prospective study was carried out from March, 2013 to September, 2013. In this study, 76 hemodialysis patients were enrolled and assigned to two unequal groups of AVF and PC. Before and after the dialysis session, blood samples were taken for laboratory examinations and measurement of urea reduction ratio (URR) and Kt/V. The patients were followed up for six months, and then laboratory examinations were repeated. Results: Of the 76 hemodialysis patients, 30 had AVF and others PC. During the 6-month follow-up, 24 patients in PC group but only one patient in AVF group showed infection (P = 0.006), while in each group, three cases of thrombosis were seen (P = 0.58); however, catheter dysfunction was seen in 13 patients of PC group but no patients of AVF group (P = 0.004). There was no difference between the two groups in Kt/V and URR at the beginning of the study; however, after six months, Kt/V and URR were greater in AVF group (P < 0.05). Conclusions: In addition to some advantages of AVF over PC, such as lower rate of infection and thrombosis, we also found better dialysis adequacy in AVF group. We recommend that AVF be created in all of patients with chronic kidney disease who are candidates for hemodialysis.

Keywords

1.
Hallan SI, Coresh J, Astor BC, Asberg A, Powe NR, Romundstad S, et al. International comparison of the relationship of chronic kidney disease prevalence and ESRD risk. J Am Soc Nephrol 2006;17:2275-84.  Back to cited text no. 1
    
2.
Eriksen BO, Ingebretsen OC. The progression of chronic kidney disease: A 10-year population-based study of the effects of gender and age. Kidney Int 2006;69:375-82.  Back to cited text no. 2
    
3.
Go AS, Chertow GM, Fan D, McCulloch CE, Hsu CY. Chronic kidney disease and the risks of death, cardiovascular events, and hospitalization. N Engl J Med 2004;351:1296-305.  Back to cited text no. 3
    
4.
Fox CS, Larson MG, Leip EP, Culleton B, Wilson PW, Levy D. Predictors of new-onset kidney disease in a community-based population. JAMA 2004;291:844-50.  Back to cited text no. 4
    
5.
Misra M. The basics of hemodialysis equipment. Hemodial Int 2005;9:30-6.  Back to cited text no. 5
    
6.
Sinnakirouchenan R, Holley JL. Peritoneal dialysis versus hemodialysis: Risks, benefits, and access issues. Adv Chronic Kidney Dis 2011;18:428-32.  Back to cited text no. 6
    
7.
Lee T, Barker J, Allon M. Tunneled catheters in hemodialysis patients: Reasons and subsequent outcomes. Am J Kidney Dis 2005;46:501-8.  Back to cited text no. 7
    
8.
Fan PY, Schwab SJ. Vascular access: Concepts for the 1990s. J Am Soc Nephrol 1992;3:1-11.  Back to cited text no. 8
    
9.
Robbin ML, Chamberlain NE, Lockhart ME, Gallichio MH, Young CJ, Deierhoi MH, et al. Hemodialysis arteriovenous fistula maturity: US evaluation. Radiology 2002;225:59-64.  Back to cited text no. 9
    
10.
Allon M, Robbin ML. Increasing arteriovenous fistulas in hemodialysis patients: Problems and solutions. Kidney Int 2002;62:1109-24.  Back to cited text no. 10
    
11.
Vascular Access Work Group. Clinical practice guidelines for vascular access. Am J Kidney Dis 2006;48 Suppl 1:S248-73.  Back to cited text no. 11
    
12.
Hirth RA, Turenne MN, Woods JD, Young EW, Port FK, Pauly MV, et al. Predictors of type of vascular access in hemodialysis patients. JAMA 1996;276:1303-8.  Back to cited text no. 12
    
13.
Ifudu O, Macey LJ, Homel P, Hyppolite JC, Hong J, Sumrani N, et al. Determinants of type of initial hemodialysis vascular access. Am J Nephrol 1997;17:425-7.  Back to cited text no. 13
    
14.
Coli' L, Cuna V, Capelli I, Kwin C, Donati G, La Manna G, et al. When native arteriovenous fistula is not possible: The permanent catheter is better. G Ital Nefrol 2009;26:154-7.  Back to cited text no. 14
    
15.
Allon M. Dialysis catheter-related bacteremia: Treatment and prophylaxis. Am J Kidney Dis 2004;44:779-91.  Back to cited text no. 15
    
16.
Stevenson KB, Hannah EL, Lowder CA, Adcox MJ, Davidson RL, Mallea MC, et al. Epidemiology of hemodialysis vascular access infections from longitudinal infection surveillance data: Predicting the impact of NKF-DOQI clinical practice guidelines for vascular access. Am J Kidney Dis 2002;39:549-55.  Back to cited text no. 16
    
17.
Tanriover B, Carlton D, Saddekni S, Hamrick K, Oser R, Westfall AO, et al. Bacteremia associated with tunneled dialysis catheters: Comparison of two treatment strategies. Kidney Int 2000;57:2151-5.  Back to cited text no. 17
    
18.
Smits JH, van der Linden J, Blankestijn PJ, Rabelink TJ. Coagulation and haemodialysis access thrombosis. Nephrol Dial Transplant 2000;15:1755-60.  Back to cited text no. 18
    
19.
Knoll GA, Wells PS, Young D, Perkins SL, Pilkey RM, Clinch JJ, et al. Thrombophilia and the risk for hemodialysis vascular access thrombosis. J Am Soc Nephrol 2005;16:1108-14.  Back to cited text no. 19
    
20.
Taylor G, Gravel D, Johnston L, Embil J, Holton D, Paton S; Canadian Nosocomial Infection Surveillance Program; Canadian Hospital Epidemiology Committee. Incidence of bloodstream infection in multicenter inception cohorts of hemodialysis patients. Am J Infect Control 2004;32:155-60.  Back to cited text no. 20
    
21.
Mermel LA, Farr BM, Sherertz RJ, Raad II, O'Grady N, Harris JS, et al. Guidelines for the management of intravascular catheter-related infections. J Intraven Nurs 2001;24:180-205.  Back to cited text no. 21
    
22.
Saad TF. Bacteremia associated with tunneled, cuffed hemodialysis catheters. Am J Kidney Dis 1999;34:1114-24.  Back to cited text no. 22
    
23.
Moyano MJ, Salgueira M, Aresté N, Escalera B, del Toro N, Jiménez-Víbora E, et al. Comparative study of PTFE grafts in forearm vs cuffed permanent catheters. Nefrologia 2006;26:594-9.  Back to cited text no. 23
    
24.
Moist LM, Hemmelgarn BR, Lok CE. Relationship between blood flow in central venous catheters and hemodialysis adequacy. Clin J Am Soc Nephrol 2006;1:965-71.  Back to cited text no. 24
    
25.
Kukavica N, Resic H, Sahovic V. Comparison of complications and dialysis adequacy between temporary and permanent tunnelled catheter for haemodialysis. Bosn J Basic Med Sci 2009;9:265-70.  Back to cited text no. 25
    
26.
Ethier J, Mendelssohn DC, Elder SJ, Hasegawa T, Akizawa T, Akiba T, et al. Vascular access use and outcomes: An international perspective from the dialysis outcomes and practice patterns study. Nephrol Dial Transplant 2008;23:3219-26.  Back to cited text no. 26
    
27.
Tonelli M, Muirhead N. Access type as a predictor of dialysis adequacy in chronic hemodialysis patients. ASAIO J 2000;46:279-82.  Back to cited text no. 27
    
28.
Canaud B, Leray-Moragues H, Garrigues V, Mion C. Permanent twin catheter: A vascular access option of choice for haemodialysis in elderly patients. Nephrol Dial Transplant 1998;13 Suppl 7:82-8.  Back to cited text no. 28
    
29.
Lee T, Barker J, Allon M. Comparison of survival of upper arm arteriovenous fistulas and grafts after failed forearm fistula. J Am Soc Nephrol 2007;18:1936-41.  Back to cited text no. 29
    
30.
Hicks CW, Canner JK, Arhuidese I, Zarkowsky DS, Qazi U, Reifsnyder T, et al. Mortality benefits of different hemodialysis access types are age dependent. J Vasc Surg 2015;61:449-56.  Back to cited text no. 30
    
31.
Banerjee T, Kim SJ, Astor B, Shafi T, Coresh J, Powe NR. Vascular access type, inflammatory markers, and mortality in incident hemodialysis patients: The choices for healthy outcomes in caring for end-stage renal disease (CHOICE) study. Am J Kidney Dis 2014;64:954-61.  Back to cited text no. 31
    
32.
Karkar A, Chaballout A, Ibrahim MH, Abdelrahman M, Al Shubaili M. Improving arteriovenous fistula rate: Effect on hemodialysis quality. Hemodial Int 2014;18:516-21.  Back to cited text no. 32
    
33.
Miller PE, Tolwani A, Luscy CP, Deierhoi MH, Bailey R, Redden DT, et al. Predictors of adequacy of arteriovenous fistulas in hemodialysis patients. Kidney Int 1999;56:275-80.  Back to cited text no. 33
    
34.
Fokou M, Teyang A, Ashuntantang G, Kaze F, Eyenga VC, Chichom Mefire A, et al. Complications of arteriovenous fistula for hemodialysis: An 8-year study. Ann Vasc Surg 2012;26:680-4.  Back to cited text no. 34
    
35.
Beigi AA, Sadeghi AM, Khosravi AR, Karami M, Masoudpour H. Effects of the arteriovenous fistula on pulmonary artery pressure and cardiac output in patients with chronic renal failure. J Vasc Access 2009;10:160-6.  Back to cited text no. 35