Introduction:
Burden of Chronic Kidney Disease (CKD) is increasing in Bangladesh. The prevalence of CKD in Bangladesh is much higher than its global prevalence. Most of the Bangladeshi End Stage Kidney Disease (ESKD) patients who can avail Renal Replacement Therapy (RRT) undergo hemodialysis. For maintenance hemodialysis it is necessary to have patent Arteriovenous Fistula (AVF). We evaluate the outcome of AVF in a single centre in Bangladesh.
Methods:
This is an observational study to evaluate the outcome of AVF after AVF surgery. This study was done in Sylhet M A G Osmani Medical College Hospital Sylhet, Bangladesh from January 2023 to June 2024. 50 (Fifty) patients having maintenance hemodialysis who were included in the study. All the patients underwent AVF construction by a single surgeon. We evaluated their hospital data and medical records following AVF construction for a period of 6 months after AVF construction.
Results:
Total 50 patients were included in the study. All patients had end stage renal disease. Mean (± standard deviation) age of the patients was 44.98 (± 14.52) years. Among them 35 (70%) patients were male and 15 (30%) patients were female. 45 (90%) patients had hypertension and 17 (34%) had diabetes mellitus. 13 (26%) patients had ischemic heart disease, among them 10 (76.9%) patients on medical treatment, 2 (15.4%) patients had percutaneous coronary intervention (PCI) and 1 (7.7%) patient had coronary artery bypass grafting (CABG). Radiocephalic fistula was made in 37 (74%) patients, while brachiocephalic fistula was made in 13 (26%) patients. 8 (16%) patients had primary failure of AV fistula. Out of this 8 patients 6 (75%) had radiocephalic and 2 (25%) had brachiocephalic fistula. 2 (4%) patients had secondary AVF failure. Out of this 2 patients 1 (50%) patient had radiocephalic and 1 patient (50%) had brachiocephalic fistula. Only 3 (6%) patients started hemodialysis with fistula first. The rest 47 (94%) patients started hemodialysis with central venous catheter. Among them 2 (4.3%) patients did hemodialysis with permanent catheter, 9 (19.1%) patients with jugular venous catheter (JVC), 33 (70.2%) patients with femoral venous catheter (FVC) and 3 (6.4%) patients did hemodialysis with both JVC and FVC. Mean (± standard deviation) duration of hemodialysis with central venous catheter was 9.53 (± 5.20) weeks.
Conclusions:
Primary outcome of AVF surgery is comparable with the findings from neighboring countries. A multicenter nationwide study is needed to observe a overall scenario of AVF surgery outcome in Bangladesh.
I have no potential conflict of interest to disclose.
I did not use generative AI and AI-assisted technologies in the writing process.