Long-term outcome of upper limb autogenous arteriovenous fistulas for hemodialysis access.

Provision of a reliable and durable vascular access for hemodialysis continues to be a challenge for clinicians. The aim of this study was to examine the outcome of upper limb autogenous arteriovenous fistula procedures for hemodialysis and factors influencing access survival. A retrospective review was carried out on 575 patients who underwent 842 consecutive vascular access procedures done over a period of ten-years. The overall primary failure rate was 5.5%, whereas the one- and five-year cumulative access survival rates were 70.0% and 52.1%, respectively. Diabetes mellitus status significantly influenced access survival (P = 0.022). Autogenous arteriovenous fistulas are reliable procedures with access sites often available in both the forearm and the arm. Patients with diabetes mellitus have significantly worse patency rates of upper limb autogenous arteriovenous fistulae.