Effect of spontaneous closure of arteriovenous fistula access on cardiac structure and function in renal transplant patients.
OBJECTIVE
The effect of spontaneous closure of arteriovenous fistula (AVF) used for hemodialysis on the heart is not adequately studied. The aim of this study was to assess the effect of spontaneous AVF closure in the early period after renal transplantation on the patient's outcome.


METHODS
Seventeen patients (13 males, 4 females) who had their AVF thrombosed within the first month after transplantation were retrospectively compared to another well-matched and persistent AVF group of patients comprising of 34 patients (27 males, 7 females). Echocardiographic assessment was done before transplantation and at 1 year after transplantation.


RESULTS
In the thrombosed fistula group, there was a trend towards lower values of left ventricular end-systolic and end-diastolic diameters as well as end-systolic and end-diastolic volumes of the left ventricle, but it did not reach statistical significance. The persistent AVF group had significantly higher estimates for cardiac output and cardiac index (p < 0.05). Both groups were comparable for left ventricular mass, left ventricular mass index, and left ventricular systolic and diastolic functions. There was no difference regarding patient and graft survival in both groups.


CONCLUSIONS
Spontaneous AVF thrombosis did not offer a cardiac beneficial effect and routine fistula closure is not warranted.
Urology and Nephrology Center, Mansoura University, Mansoura 33516, Egypt. drhattia@yahoo.com
Hussein
H
Sheashaa
Nabil
N
Hassan
Yasser
Y
Osman
Alaa
A
Sabry
Mohamed
M
Sobh
D000328:Adult; D001166:Arteriovenous Shunt, Surgical; D002302:Cardiac Output; D004452:Echocardiography; D005260:Female; D005500:Follow-Up Studies; D006085:Graft Survival; D006801:Humans; D007676:Kidney Failure, Chronic / Q000401:mortality* / Q000601:surgery*; D016030:Kidney Transplantation / Q000401:mortality*; D008297:Male; D012189:Retrospective Studies; D013927:Thrombosis / Q000401:mortality*; D016277:Ventricular Function, Left