title: Obesity is not an obstacle for successful autogenous arteriovenous fistula creation in haemodialysis.
abstract: 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.
authors.affiliation: Department of Nephrology and Transplantation Medicine, Wroclaw Medical University, Traugutta 57/59, 50-417 Wroclaw, Poland. klinef@am.centrum.pl
authors.forename: Waclaw
authors.initials: W
authors.lastname: Weyde
authors.forename: Magdalena
authors.initials: M
authors.lastname: Krajewska
authors.forename: Waldemar
authors.initials: W
authors.lastname: Letachowicz
authors.forename: Tomasz
authors.initials: T
authors.lastname: Porazko
authors.forename: Ewa
authors.initials: E
authors.lastname: Watorek
authors.forename: Mariusz
authors.initials: M
authors.lastname: Kusztal
authors.forename: Miroslaw
authors.initials: M
authors.lastname: Banasik
authors.forename: Tomasz
authors.initials: T
authors.lastname: Golebiowski
authors.forename: Hanna
authors.initials: H
authors.lastname: Bartosik
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Madziarska
authors.forename: Dariusz
authors.initials: D
authors.lastname: Janczak
authors.forename: Marian
authors.initials: M
authors.lastname: Klinger
mesh_terms: 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