Isabelle Kolb1, Théogène Twagirumugabe2, Innocent Uyisabye3, Jérôme Muhizi4, Laura Braun-Parvez5, Sarah Richter6, Joseph Ntarindwa7, Jean-de-Dieu Nzambaza8, Richard Rwandenzi8, Martine Kibuka7, Françoise Mantz9. 1. Service de néphrologie-hémodialyse, clinique Sainte-Anne, 182, route de la Wantzenau, 67085 Strasbourg cedex, France. Electronic address: kolbi4@wanadoo.fr. 2. Service d'anesthésie-réanimation, centre hospitalier universitaire de Butare, Province-du-Sud BP 254, Butare, Rwanda. 3. Service de chirurgie générale, centre hospitalier universitaire de Kigali, boulevard de la Paix, Kigali, Rwanda. 4. Service d'anesthésie-réanimation, hôpital militaire de Kanombe, Kicukiro 23, Kigali, Rwanda. 5. Service de néphrologie-hémodialyse, centre hospitalier universitaire de Strasbourg, 1, place de l'Hôpital, 67000 Strasbourg, France. 6. Service de néphrologie-hémodialyse, clinique Sainte-Anne, 182, route de la Wantzenau, 67085 Strasbourg cedex, France. 7. Service d'hémodialyse, King Faisal hospital, PO box 2534, Kigali, Rwanda. 8. Service d'hémodialyse, centre hospitalier universitaire de Butare, Province-du-Sud BP 254, Butare, Rwanda. 9. Service de chirurgie vasculaire, clinique de l'Orangerie, 29, allée de la Robertsau, 67000 Strasbourg, France.
Abstract
UNLABELLED: Chronic hemodialysis in Rwanda is relatively recent and most of patients are treated with catheters. SUMMARY: Thirty-seven patients who require chronic hemodialysis with catheters were evaluated during a 3-years period in order to facilitate the creation of a permanent vascular access for hemodialysis (AVF). Patient selection were made during a multi-disciplinary consultation. The sex-ratio was 1.5 and the main cause of the nephropathy was arterial hypertension. RESULTS: Thirty-one patients benefited from the creation of an arterioveinous fistula. All of the interventions were performed using local or loco-regional anesthesia. Sixty percent of these AVF were radio-cephalic, 35.4% were humero-cephalic. Sixty-four percent of the operations were performed on ambulatory patients, with a primary function for 90% of them. CONCLUSION: This work proves the feasibility of the creation of AVF in Rwanda, thus allowing to preclude the various complications that arise with the prolonged use of a catheter. This experience was made possible by the pooling of the resources of 4 of Rwanda's leading hospitals. In an early future, the development of vascular surgery will assure the permanence of this care.
UNLABELLED: Chronic hemodialysis in Rwanda is relatively recent and most of patients are treated with catheters. SUMMARY: Thirty-seven patients who require chronic hemodialysis with catheters were evaluated during a 3-years period in order to facilitate the creation of a permanent vascular access for hemodialysis (AVF). Patient selection were made during a multi-disciplinary consultation. The sex-ratio was 1.5 and the main cause of the nephropathy was arterial hypertension. RESULTS: Thirty-one patients benefited from the creation of an arterioveinous fistula. All of the interventions were performed using local or loco-regional anesthesia. Sixty percent of these AVF were radio-cephalic, 35.4% were humero-cephalic. Sixty-four percent of the operations were performed on ambulatory patients, with a primary function for 90% of them. CONCLUSION: This work proves the feasibility of the creation of AVF in Rwanda, thus allowing to preclude the various complications that arise with the prolonged use of a catheter. This experience was made possible by the pooling of the resources of 4 of Rwanda's leading hospitals. In an early future, the development of vascular surgery will assure the permanence of this care.