#6282 MAKING DECISION OF VASCULAR ACCESS TYPE BASED ON UPPER ARM DOPPLER PARAMETERS AMONG INCIDENT HEMODIALYSIS PATIENTS: A SINGLE CENTER EXPERIENCE

Abstract Background and Aims Functional vascular access (VA) remains one of the most important problems related to successful hemodialysis (HD) treatments. Pivotal issue related to inadequate vascular access is decision making process of which type of VA should be created at start. Therefore, the aim of our study is to examine possible impact of Doppler examination of upper arm on decision of VA type creation. Method During 5 year period (January 2018th- December 2022th), 260 patients started hemodialysis in our department. Among them, 18 died during the first three months after HD was started, 3 were transferred to other hospitals for chronic HD program and 5 have created vascular access in other hospitals. So, we analyzed data for 234 patients (No=150, 63.6% males, mean age 62.6±13.8) which vascular access were created in our Center. We have divided them into two groups (Group A-patients with arterio-venous fistula (AVF) as first created VA and group B-patients with arterio-venous graft (AVG) or permanent central venous catheter (pCVK) as first created VA. From medical records, we have collected demographic data, type of created vascular access, Doppler parameters of upper arm and laboratory findings. Results Out of 234 patients, in Group A were167 patients (male No=109, 65.2%, mean age 61.0 years±13.8), while in group B were 67 patients(male No=40, 59.7% mean age 66.8 years±13.2). In table 1, demographic, laboratory and Doppler data is presented. We found that in Group A patients are statistically younger (61.0 years ±13.8 vs 66.8 years ±13.2, P = .004) and their vena cephalica (2.9mm± 2.5 vs 1.9mm±0.1, P = .000) and arteria radialis (2.2mm±0.4 vs 1.9mm±0.1, P = .002) are with better diameters. Also, their protein levels were statistically lower (69±9 vs 78±3, P = .036) and CRP levels higher (21.2±35.3 vs 8.1±2.1, P = .000) compared to Group B. Binary logistic regression revealed that there are no statistically significant variables that could impact decision to create AVF, but larger diameter of vena cephalica increase this decision over 13 fold (OR 13.497, CI 0.706-257.868, P = .084), and diameter of arteria radialis 17 fold (OR 17.073, CI 0.372-784-182, P = .146). Conclusion Diameteres of vena cephalica and arteria radialis could be the main variables in the planning of type of vascular access.