Vascular abnormalities in patients with autosomal dominant polycystic kidney disease--the influence on arteriovenous fistula creation.
OBJECTIVE
Patients with autosomal dominant polycystic kidney (ADPKD) present a number of vascular abnormalities, including cerebral aneurysms, heart valve lesions, coarctations of aorta and abdominal aortic aneurysms. The aim of our study was to investigate whether vascular abnormalities that occur in wrist vessels, make native arteriovenous fistula creation difficult in this group of patients.


METHODS
The problem was analyzed retrospectively in 783 patients with chronic kidney failure who had had arteriovenous fistula created in our centre in the period between 1991 and 2001. ADPKD was the cause of terminal renal failure in 57 patients (7.3%). These were 31 men and 26 women aged 28 - 69 years (52 +/- 16 years on average).


RESULTS
A difference between left and right radial artery diameters and a narrow radial artery (below 2 mm), unsuitable for fistula creation, occurred in 12% of patients with ADPKD and in 0.38% of other patients. Instead of a cephalic vein in the typical place, a few small vessels were present in 14% of patients with ADPKD and in 2.17% of patients with other causes of renal failure.


CONCLUSIONS
Our experience shows a higher incidence of wrist vascular abnormalities in patients with ADPKD. This decreases the possibility of wrist native arteriovenous fistula creation in this group of patients.
Weyde
W
W
Department of Nephrology and Transplantation Medicine, University of Medicine, Wroclaw, Poland. klinef@am.centrum.pl
Krajewska
M
M
Penar
J
J
Bartosik
H
H
Klinger
M
M
D001166:Arteriovenous Shunt, Surgical; D001808:Blood Vessels / Q000002:abnormalities*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016891:Polycystic Kidney, Autosomal Dominant / Q000150:complications*; D017534:Radial Artery / Q000002:abnormalities; D012189:Retrospective Studies; D014953:Wrist / Q000098:blood supply*