One Year Patency Rate and Primary Failure Rate as Vascular Access in End-Stage Renal Disease

Abstract

Background:  End-stage renal disease patients are increasing. Treatment for patients in this stage is renal replacement therapy and hemodialysis is one method of treatment. The long-term hemodialysis option is permanent vascular access surgery, divided into arteriovenous fistula(AVF) and prosthetic arteriovenous graft(AV-graft)

Objective: Report on the result of permanent vascular access in patients with end-stage renal disease, one year patency rate and primary failure rate.

method: This is a retrospective cohort study from the medical records of 175 patients who were diagnosed with end-stage renal disease and underwent permanent vascular access surgery at Samut Prakan Hospital from 1 June 2022 to 31 May 2024. Collect general characteristics of patients. Surgery method Results of treatment and postoperative complications were analyzed for statistical data

Results: There were 175 patients who underwent permanent vascular access surgery. The average age was 57.27 years. Sixty eight percent were males. The most common associated disease was hypertension, 172 (98.28%). The most commonly used permanent hemodialysis surgery method was radiocephalic AVF in 115 cases (65.70%) followed by brachiocephalic AVF in 46 cases (26.30%). One year patency rate was 73.71 percent. Primary failure of hemodialysis in 37 cases (21.10%) and complications of bleeding were found after surgery in 1 case (0.6%). By the surgical method that found the least one year patency (64.35 percent) and the highest primary failure (29.56 percent) was radiocephalic AVF.

Conclusion: In research, permanent vascular access surgery has a one year patency rate and primary failure is similar to other studies. Preemptive hemodialysis access can increase patency rate and the use of duplex ultrasound can reduce Primary failure is possible.