Andrew S Kucey1, Doireann P Joyce2, Teresa O'Neill3, Gregory J Fulton4,2, William D Plant4,3, Brian J Manning4,2. 1. School of Medicine, University College Cork, Cork, Republic of Ireland. 116100312@umail.ucc.ie. 2. Department of Vascular Surgery, Cork University Hospital, Wilton, Cork, Republic of Ireland. 3. Department of Renal Medicine, Cork University Hospital, Wilton, Cork, Republic of Ireland. 4. School of Medicine, University College Cork, Cork, Republic of Ireland.
Abstract
OBJECTIVES: With lower rates of sepsis and re-interventions, arteriovenous fistula (AVF) is the preferred vascular access modality. The aim of this study is to evaluate the outcomes of patients referred for AVF construction at a single center in Cork, Ireland. METHODS: The current study is a single-center retrospective review of all patients who underwent AVF creation between 2015 and 2017. Additionally, the kidney disease clinical patient management system was used to provide statistics on AVF use in Ireland. RESULTS: 39.3% of hemodialysis patients in Ireland use an AVF for vascular access. Regional use ranged from 50 to 20% across Irish hemodialysis centers. At Cork University Hospital, 192 AVFs were created. The population was 69.3% male (n = 133), 30.7% female (n = 59) with a mean (±SEM) age of 58.8 ± 1.03 years. 69.5% of females received a brachiocephalic AVF (BCAVF) while 13.6% had a radiocephalic AVF (RCAVF) constructed. Significance was seen when comparing gender and AVF type (p < 0.001). Fifty-four percent of the fistulae were brachiocephalic (n = 103), 33% were radiocephalic (n = 63), and 4% were brachiobasilic (n = 8). BCAVF patients (62.7 ± 1.2 years) were significantly older than patients receiving a RCAVF (54.5 ± 1.9 years, p < 0.001). A post-operative thrill or continuous flow on Doppler was present in 99% of patients (n = 190) with maturation and complication rates of 82.7% (n = 153) and 5.7% (n = 11) respectively. 69.9% of AVFs were needled for hemodialysis (n = 114). CONCLUSIONS: AVF outcomes at this center are consistent with reported statistics in the literature. Patient age, sex, and diabetic status may influence the use of proximal AVF. AVF creation rates in Ireland are below international reported recommendations.
OBJECTIVES: With lower rates of sepsis and re-interventions, arteriovenous fistula (AVF) is the preferred vascular access modality. The aim of this study is to evaluate the outcomes of patients referred for AVF construction at a single center in Cork, Ireland. METHODS: The current study is a single-center retrospective review of all patients who underwent AVF creation between 2015 and 2017. Additionally, the kidney disease clinical patient management system was used to provide statistics on AVF use in Ireland. RESULTS: 39.3% of hemodialysis patients in Ireland use an AVF for vascular access. Regional use ranged from 50 to 20% across Irish hemodialysis centers. At Cork University Hospital, 192 AVFs were created. The population was 69.3% male (n = 133), 30.7% female (n = 59) with a mean (±SEM) age of 58.8 ± 1.03 years. 69.5% of females received a brachiocephalic AVF (BCAVF) while 13.6% had a radiocephalic AVF (RCAVF) constructed. Significance was seen when comparing gender and AVF type (p < 0.001). Fifty-four percent of the fistulae were brachiocephalic (n = 103), 33% were radiocephalic (n = 63), and 4% were brachiobasilic (n = 8). BCAVFpatients (62.7 ± 1.2 years) were significantly older than patients receiving a RCAVF (54.5 ± 1.9 years, p < 0.001). A post-operative thrill or continuous flow on Doppler was present in 99% of patients (n = 190) with maturation and complication rates of 82.7% (n = 153) and 5.7% (n = 11) respectively. 69.9% of AVFs were needled for hemodialysis (n = 114). CONCLUSIONS: AVF outcomes at this center are consistent with reported statistics in the literature. Patient age, sex, and diabetic status may influence the use of proximal AVF. AVF creation rates in Ireland are below international reported recommendations.
Authors: Carrie A Schinstock; Robert C Albright; Amy W Williams; John J Dillon; Eric J Bergstralh; Bernice M Jenson; James T McCarthy; Karl A Nath Journal: Clin J Am Soc Nephrol Date: 2011-07-07 Impact factor: 8.237
Authors: Kevin de Leur; Cigdem Oztürk; Michiel L P Van Zeeland; Hans G W de Groot; Jan M M Heyligers; Patrick W H E Vriens; Gwan H Ho; Lijckle van der Laan Journal: Vasc Endovascular Surg Date: 2013-07-12 Impact factor: 1.089
Authors: Jeffrey Perl; Sharon J Nessim; Louise M Moist; Ron Wald; Yingbo Na; Karthik K Tennankore; Christopher T Chan Journal: Am J Kidney Dis Date: 2015-09-19 Impact factor: 8.860
Authors: Josef Coresh; Elizabeth Selvin; Lesley A Stevens; Jane Manzi; John W Kusek; Paul Eggers; Frederick Van Lente; Andrew S Levey Journal: JAMA Date: 2007-11-07 Impact factor: 56.272
Authors: Laura M Dember; Gerald J Beck; Michael Allon; James A Delmez; Bradley S Dixon; Arthur Greenberg; Jonathan Himmelfarb; Miguel A Vazquez; Jennifer J Gassman; Tom Greene; Milena K Radeva; Gregory L Braden; T Alp Ikizler; Michael V Rocco; Ingemar J Davidson; James S Kaufman; Catherine M Meyers; John W Kusek; Harold I Feldman Journal: JAMA Date: 2008-05-14 Impact factor: 56.272
Authors: Paul Arora; Priya Vasa; Darren Brenner; Karl Iglar; Phil McFarlane; Howard Morrison; Alaa Badawi Journal: CMAJ Date: 2013-05-06 Impact factor: 8.262
Authors: Jürgen Floege; Iain A Gillespie; Florian Kronenberg; Stefan D Anker; Ioanna Gioni; Sharon Richards; Ronald L Pisoni; Bruce M Robinson; Daniele Marcelli; Marc Froissart; Kai-Uwe Eckardt Journal: Kidney Int Date: 2015-02-04 Impact factor: 10.612
Authors: Austin G Stack; Liam F Casserly; Cornelius J Cronin; Tetyana Chernenko; Walter Cullen; Ailish Hannigan; Rajiv Saran; Howard Johnson; Gemma Browne; John P Ferguson Journal: BMC Nephrol Date: 2014-11-25 Impact factor: 2.388
Authors: Chava L Ramspek; Rosemarijn Boekee; Marie Evans; Olof Heimburger; Charlotte M Snead; Fergus J Caskey; Claudia Torino; Gaetana Porto; Maciej Szymczak; Magdalena Krajewska; Christiane Drechsler; Christoph Wanner; Nicholas C Chesnaye; Kitty J Jager; Friedo W Dekker; Maarten G J Snoeijs; Joris I Rotmans; Merel van Diepen Journal: Kidney Int Rep Date: 2022-08-02