Obesity is not an obstacle for successful autogenous arteriovenous fistula creation in haemodialysis.
BACKGROUND
Obesity, which is often associated with diabetes, is increasingly encountered in the haemodialysed population, and this may produce difficulty in autogenous arteriovenous fistula creation. Prosthetic angioaccess or catheters, when used in place of autogenous fistulas, increase thrombotic and infectious complications in these already challenged patients.


METHODS
This prospective study was undertaken to assess the feasibility of autogenous arteriovenous fistula creation in 71 obese patients (BMI 34.6 +/- 7.8). We performed a two-stage procedure, in which radio-cephalic fistula formation was followed by subcutaneous transposition of the venous component for safe and easy puncture.


RESULTS
Fistulas suitable for puncture, having blood flows of 799 +/- 285 ml/min, and sufficient to perform adequate haemodialysis (Kt/V 1.24) were achieved in 85% of the patients. Primary patency rates were 65% and 59% at 6 and 12 months, respectively, and secondary patency rates were 83% both at 6 and 12 months.


CONCLUSIONS
Obesity does not prevent successful autogenous arteriovenous fistula formation, and may protect forearm venous vessels from the iatrogenic damage that occurs before the onset of haemodialysis therapy.
Weyde
Waclaw
W
Department of Nephrology and Transplantation Medicine, Wroclaw Medical University, Traugutta 57/59, 50-417 Wroclaw, Poland. klinef@am.centrum.pl
Krajewska
Magdalena
M
Letachowicz
Waldemar
W
Porazko
Tomasz
T
Watorek
Ewa
E
Kusztal
Mariusz
M
Banasik
Miroslaw
M
Golebiowski
Tomasz
T
Bartosik
Hanna
H
Madziarska
Katarzyna
K
Janczak
Dariusz
D
Klinger
Marian
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001166:Arteriovenous Shunt, Surgical / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications*; D011446:Prospective Studies; D006435:Renal Dialysis / Q000379:methods*; D016896:Treatment Outcome