management of repeated repeated long-term access to the vascular system is essential in care of patients with end stage renal disease (ESRD) treated with hemodialysis. With aging dialysis population and increasing number of patients with
peripheral
vascular diseases such as diabetes mellitus, maintenance of adequate vascular access ins clinically important. So we observed 9 parameters including underlying diseases, age, sex, site of AV fistula on 206 ESRD patients with hemodialysis from 6
hospitals for survival rate of AV fistula in chronic hemodialysis patients.
@ES The following results were obtained:
@EN 1) In 206 patients population, more than half (53.%) were avove 50 year old, and frequent underlying renal diseases were CGN (34.5%), diabetic nephropathy (25.2%0, hypertensive nephropathy (18.4%).
2) Main type of AV fistula was radio-cephalic type (90.3%), end-to-side anastomosis (46%), an forearm (72%) was most frequent site of AV fistula.
3) Complications of AV fistula were thrombosis (22 cases), aneurysm (5 cases), venous hypertension, infection, but incidence of thrombosis was higher significantly in older patients (4 times), in diabetic patients (5 times)(p<0.05).
4) Average 1 year, 2 year and 3 year survival rates of AV fistulas in total population were 86.5%, 83.0%, 79.5%, and the mean survival period was 38.2months. mean survival rate of AV fistulas in older patients was lower significantly than in
younger
patients. (p<0.05).
Comparing to non-diabetic patients, 1 year, 2 year and 3 year survival rates of AV fistulas in diabetic patients wer lowere significantly. (p<0.05)
But, type & site of AV fistula, mode of anastomosis, specialty of operator, sex of patients were not correlated with fistula survival.
In conclusion, AV fistula survival rate was significantly lower in diabetic patients and old patients, so we should mange AV fistula more carefully to prevent thrombosis old & diabetic ESRD patients with hemodialysis.
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