Vascular access in hemodialysis patients – Tanta University Hospital hemodialysis center's experience

BackgroundA well-functioning vascular access is essential to provide efficient dialysis therapy. Morbidity related to vascular access is the leading cause of hospitalization in hemodialysis (HD) patients.ObjectivesTo analyze the vascular access in maintenance HD patients and to assess its associated complications.Patients and methodsA total of 101 patients on regular HD were included, and data were collected through a preformed questionnaire focusing on vascular access.ResultsOf the 101 patients studied, the vascular access at initiation of HD was temporary catheter in 95% and arteriovenous fistula (AVF) in 5% of the patients. Current vascular access was native AVF in 94%, temporary catheters in 1%, and permanent tunneled cuffed catheter in 5% of the patients. No arteriovenous graft was created. A tunneled catheter was inserted in the internal jugular vein in 99% of cases. A native AVF was created in 99% of the patients as the first permanent access. It was radioscephalic in 35%. The primary failure rate was 14%. The commonest complication with AVF was thrombosis (21%).ConclusionTemporary dialysis catheters were the most common initial vascular access. Native AVF was the most common vascular access. Thrombosis was the most common complication.