ARTERIOVENOUS FISTULA DYSFUNCTION IN PATIENTS ON MAINTENANCE HEMODIALYSIS IN FOUR HEMODIALYSIS CENTERS IN CAMEROON

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https://storage.unitedwebnetwork.com/files/1099/85230b92045b3435c5a3f6f5ba65e120.pdf

Abstract Title

First Name *

RONALD

Last Name *

GOBINA

Co-author 1

Midrelle Syntyche Tsague midrelletsague@gmail.com Buea Regional Hsopital Department of Internal Medicine Buea

Co-author 2

Eunice Oben obeneunice44@gmail.com Buea Regional Hospital Department of Internal Medicine Buea

Co-author 3

Maurine Monono maurineevenye@gmail.com Buea Regional Hospital Department of Internal Medicine Buea

Co-author 4

Mokake Martin divymoks2001@yahoo.com Faculty of Health Sciences, University of Buea; Buea Regional Hospital Department of Surgery Buea

Co-author 5

Denis Teuwafeu d.teuwafeu@yahoo.com Faculty of Health Sciences, University of Buea; Buea Regional Hospital Department of Internal Medicine and Pediatrics Buea

Co-author 6

Co-author 7

Co-author 8

Co-author 9

Co-author 10

Co-author 11

Co-author 12

Co-author 13

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Co-author 15

Introduction

Arteriovenous Fistula (AVF) is the recommended vascular access for maintenance hemodialysis. Monitoring of AVF can help to detect early signs and symptoms of Arteriovenous Fistulas dysfunction for a better care plan. Our aim was to determine the proportion and patterns of Arteriovenous Fistula dysfunction, and identify associated factors.

Methods

This was a hospital-based cross-sectional study in four hemodialysis centers in Cameroon. All consenting patients with an AVF were recruited. We excluded patients with an AVF younger than 6 weeks and those with an unsuccessful first cannulation. Socio-demographic and clinical data was extracted from patients and their AVFs examined. Data was analyzed using IBM-SPSS version 28.0; univariate and multivariate analysis were used to test for association and statistical significance was set at p value< 0.05 at 95% confidence interval.

Results

A total of 406 participants were included in our study, 61.6% were males. The mean age (SD) was 46.3 (14.7) years. Hypertension (82.8%), diabetes (15.3%), and heart failure (15.3%) were the most prevalent comorbidities. AVF was the vascular access at dialysis initiation for 77 (19%) patients, the rest being central venous catheters. Creation of AVF was by a surgeon for 373 (91.9%) and by nephrologist for 33 (8.1%). Among our patients, 137 (33.7%) had one or more types of AVF dysfunction, with a cumulative total of 147 AFV dysfunctions. Aneurysm was the most common type of dysfunction followed by outflow stenosis and central venous stenosis, in 135 (33.3%), 10 (2.5%) and 2 (0.5%) cases respectively. Factors independently associated with AFV dysfunction included diabetes (p<0.001), heart failure (p=0.009), duration on dialysis (p=0.029) and history of previous AVF dysfunction (p=0.009).

Conclusions

Arteriovenous fistula dysfunction was present in 33.3% of patients. The clinical patterns included aneurysm, outflow stenosis and central venous stenosis. Diabetes, heart failure, duration on dialysis and history of fistula dysfunction were associated with arteriovenous fistula dysfunction.

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