An Experience of Arteriovenous Fistulas Created for Hemodialysis in the Largest Health Center in Eastern Turkey

Figures & data

Table 1. Preoperative parameters in fistula patients.

Variable	Male	Female	Total
Number of operations	831	698	1529
Number of patients	611	392	1003
Adults	498	395	893
Smoking	539	175	714
HT	413	227	640
DM	203	166	369
CAD	87	67	154
Pediatrics	36	74	110
CVE	71	36	107
CABG	51	23	74
PABG	31	8	39

Note: HT, hypertension; DM, diabetes mellitus; CAD, coronary artery disease; CABG, coronary artery bypass grafting; PABG, peripheral artery bypass grafting; CVE, cerebrovascular event.

Table 2. Causes for hemodialysis.

Causes	Male	Female	Total
Diabetic nephropathy	203	166	369
Glomerulonephritis	154	70	224
Chronic pyelonephritis	107	100	207
Polycystic kidney disease	83	80	163
Others	30	10	40

Table 3. Types of fistulas.

Localization	Primary fistula	Reoperation fistula
Total	1003	526
Radial–cephalic AVF	572	312
Brachial–cephalic AVF	234	101
Brachial–basilic AVF	75	45
VSM loop to SFA AVF	46	28
Brachial–axillary AVG	44	23
SFA to femoral vein AVG	17	9
Brachial–cephalic AVG	15	8

Note: AVF, arteriovenous fistula; AVG, arteriovenous graft; VSM, vena saphena magna; SFA, superficial femoral artery.

Table 4. Indications for second and further reoperations.

Indications for reoperations	Second	Further reoperations
Total	394	132
Hemorrhage	108	36
Thrombosis	81	35
Infection	60	5
Stenosis or partial dysfunction	50	30
Pseudoaneurysm	46	4
Ischemia/steal syndrome	20	10
Venous hypertension	13	3
Hand edema	8	6
Seroma	8	3

Figure 1. Kaplan–Meier survival curves for fistula primary and secondary patency rates in 6-year follow-up.

Table 5. Life tables demonstrating primary and secondary patencies of fistulas constructed.

Time (months)	Primary patency (%)	Secondary (after reoperative) patency (%)	p-Value
0	100	100
6	72	79
12	64	70
24	51	56
48	41	46
72	26	33	0.082

Table 6. Comparisons of primary patency and secondary (after reoperation) patency fistulas with regard to some variables.

Variable	Primary fistula patency patients	Secondary (after reoperation) patency patients
Number of patients	1003	354
Number of operations	1003	526
Male/female	611/392	204/150
Mean age (years)	62 ± 11.2	57 ± 12.5
Adults	893	321
Smoking	714	301
HT	640	344
DM	369	211
Pediatrics	110	33
CVE	107	44
CABG	74	53
PABG	39	24

Note: DM, diabetes mellitus; HT, hypertension; CABG, coronary artery bypass grafting; PABG, peripheral artery bypass grafting; CVE, cerebrovascular event.

Table 7. The results of Cox regression analysis on the factors effective on patency (p-value < 0.05: statistically significant).

	OR	95% CI	p-Value
Sex
Female	1
Male	1.010	0.988–1.025	0.711
Age	1.013	0.992–1.014	0.613
Smoke history
(−)	1
(+)	0.502	0.392–0.645	<0.05
Diabetes mellitus
(−)	1
(+)	0.379	0.215–0.668	<0.05
Hypertension
(−)	1
(+)	2.914	1.926–4.409	<0.05
Peripheral arterial disease
(−)
(+)	0.999	0.750–1.331	0.973