Evaluation of variables associated with the patency of arteriovenous fistulas for hemodialysis created by a nephrologist.

INTRODUCTION: Arteriovenous fistula (AVF) is considered the gold standard vascular access for chronic hemodialysis, and its failure predicts higher morbidity and mortality rates.

OBJECTIVE: 1) To evaluate the success rate of AVF created by a nephrologist and 2) to identify clinical, laboratory, and demographic variables that influence AVF patency.

METHODS: A retrospective cohort study of 101 patients with chronic kidney disease for a total of 159 AVF created by a nephrologist between June 2010 and June 2013.

RESULTS: Of the AVFs created, 124 (78%) displayed immediate patency and 110 (62.9%) displayed late patency. Hemoglobin (10-12 g/dL) was the only variable related to late AVF patency (p = 0.05). An elevated blood pressure at time of surgery was associated with a lower number of procedures per patient (p = 0.001). Proximal AVF occurred more frequently in patients with dual access (p = 0.03). The AVF success rate was similar to those previously reported in the literature.

CONCLUSION: Hemoglobin level in the recommended range has a favorable impact on late AVF patency and elevated blood pressure during surgery on the lower number of vascular accesses per patient. The high success rate indicates that it can be placed by trained nephrologists.