Biochemical Risk Factors Associated with Arteriovenous Fistula Failure in Hemodialysis Patients

Abstract

Background: Hemodialysis is the most common method of renal replacement therapy for end stage renal disease (ESRD) patients and the AVF is the best vascular access of choice for hemodialysis as recommended by KIDGO. AVF failure is the leading cause of morbidity and mortality for emodialysis patients. It is a challenging process in which improvement of outcome of the AVF will improve quality of life of hemodialysis patients and minimize health care resources and costs related to vascular access dysfunction. Objective: This study shows the risk factors contributing to AVF dysfunction in order to find out some preventive measures to decrease the rate of AVF failure. Patients and methods: 300 patients with ESRD were divided into 2 groups: control group: 200 patients with functioning AVF. Case group: 100 patients with AVF dysfunction. All patients included in the study were subjected to laboratory investigations (CBC, blood urea and serum creatinine, cholesterol, triglycerides, HbA1C, serum albumin, Ca, Po4, PTH, PT, INR, CRP & ESR) and imaging
in the form of Doppler ultrasound of the AVF. Results: Our study results show a significant relation between arterio-venous access and some risk factors as low hemoglobin level, high platelet count, high renal functions, dyslipidemia, hypoalbuminemia, and elevated CRP & ESR denoting the presence of inflammation. Conclusion: the most independent risk factors for AVF dysfunction were anemia, dyslipidemia, high platelets, high renal functions, hypoalbuminemia and elevated ESR & CRP.