The effect of type and vascular access quality on the outcome of chronic hemodialysis treatment.
The function of vascular access has a key significance in hemodialysis treatment results. An overview of factors contributing to successful arteriovenous fistula (AVF) constructions and the effect of vascular access quality on the outcome of renal replacement therapy were analyzed, including our study observations. On the basis of the data obtained in the study, the creation of autogenous AVF was reported to be possible in 92.9% of the 213 investigated patients. In 81.2% of the patients, vascular access was found to be located on the forearm. Comorbidities, especially congestive heart failure and peripheral vascular disease, were the main factors that had a negative effect on AVF construction and quality. AVF abnormalities were detected on physical examination in 37% of the patients. Results from the physical examination were found to be consistent with those obtained from Doppler ultrasound, thermodilution, and intra-access pressure measurement. AVF stenosis significantly increased the risk for access thrombosis, catheter insertion, and vascular access-related hospitalization.