Hemodialysis Vascular Access Complications: A 12-Month Comparative Study of Arteriovenous Fistulas and Central Venous Catheters

 

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Hemodialysis Vascular Access Complications: A 12-Month Comparative Study of Arteriovenous Fistulas and Central Venous Catheters

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NADA NECIB nada.necib@diaverum.com DIAVERUM DIALYSIS MONTERAU FAULT YONNE France *
SAMIR ALBITAR samir.albitar@diaverum.com DIAVERUM DIALYSIS MONTERAU FAULT YONNE France -
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Vascular access is pivotal to hemodialysis adequacy and patient survival. Arteriovenous fistulas (AVFs) are preferred for long-term use, while central venous catheters (CVCs) are associated with higher morbidity and complication rates. This study compared 12-month vascular access complications between AVF and CVC users in a single hemodialysis center in France.

We retrospectively analyzed 100 adult patients receiving maintenance hemodialysis between 2024 and 2025 at DIAVERUM Montereau, dialysis Unit, France. Baseline demographics and comorbidities (diabetes, hypertension, cardiovascular disease) were collected. Access type at initiation (AVF or CVC) and all access-related complications were recorded over 12 months. Events were categorized as infection (catheter-related bloodstream infection, CRBSI), thrombosis, stenosis, or mechanical dysfunction.

Of 100 patients, 68 had AVFs and 32 had CVCs. Mean age was 75.5 ± 10.7 years; 52% were male, 60% had diabetes, and 90% had hypertension. During 12 months, 42 patients (42%) experienced at least one complication, occurring more frequently in CVC users (93.8%) than AVF users (17.6%). CVC complications included mechanical dysfunction (n = 25) and CRBSI (n = 5). AVF complications comprised stenosis (n = 7) and thrombosis (n = 5); no infections or mechanical events were recorded in the AVF group.

Central venous catheters were associated with substantially higher complication rates than arteriovenous fistulas, primarily mechanical dysfunction and infection. AVF complications were dominated by stenosis and thrombosis. Early AVF creation, reduction of catheter dependence, and vigilant monitoring for stenosis are essential to optimize vascular access outcomes.

Kewords