title: Survival of the first arteriovenous fistula in 96 patients on chronic hemodialysis.
abstract: BACKGROUND
  Native arteriovenous fistula (AVF) represents the best vascular approach for chronic hemodialysis. The aim of this study was to determine the survival of the first AVF and to identify the factors responsible for poor AVF survival.
  
  
  METHODS
  A retrospective study was conducted on 96 chronic hemodialysis patients benefiting from the creation and cannulation of their first AVF at our center, with a minimum follow-up period of 1 year. We collected demographic, clinical, and biological data, as well as analyzed the following AVF characteristics: anatomic site, cannulation time, survival, and complications. To identify the predictive factors of poor AVF survival, we defined and compared two groups of patients on the basis of whether they lost their first AVF during the evolution.
  
  
  RESULTS
  Patients' mean age was 42.1 ± 13 years, with predominantly female patients. Mean AVF cannulation time was 17.5 ± 24 days. AVF loss was mainly related to thrombosis in 29% of the cases and stenosis in 9.4%. AVF survival was 87%, 77%, 71%, 67%, and 64% after 1, 3, 5, 8, and 10 years of hemodialysis, respectively. In our study, the main factors associated with AVF loss were lengthy jugular venous catheters placement (p = 0.004), short AVF cannulation time after its creation (p = 0.03), and hypotension episodes during dialysis (p = 0.03).
  
  
  CONCLUSIONS
  Long-term survival and quality of life in hemodialysis depend on an appropriate dialysis carried out-thanks to a correct vascular approach! According to the previously published data, survival of the first AVF can vary between 10% and 36% at 10 years. In our study, survival of the first native AVF was satisfying because it reached 64% at 10 years. Early AVF creation and prevention and management of its complications remain the safest and most comfortable solution to ensure AVF survival and thus a satisfying survival and quality of life in chronic hemodialysis patients.
authors: Service de Néphrologie-Dialyse-Transplantation rénale, CHU Ibn Sina, Rabat, Morocco. aicha_radoui@hotmail.com
authors: Aicha
authors: A
authors: Radoui
authors: Zineb
authors: Z
authors: Lyoussfi
authors: Intissar
authors: I
authors: Haddiya
authors: Zoubair
authors: Z
authors: Skalli
authors: Redouane
authors: R
authors: El Idrissi
authors: Hakima
authors: H
authors: Rhou
authors: Fatima
authors: F
authors: Ezzaitouni
authors: Naima
authors: N
authors: Ouzeddoun
authors: Abbes
authors: A
authors: El Mesnaoui
authors: Rabea
authors: R
authors: Bayahia
authors: Loubna
authors: L
authors: Benamar
mesh_terms: D000328:Adult; D001166:Arteriovenous Shunt, Surgical / Q000009:adverse effects; D016009:Chi-Square Distribution; D002908:Chronic Disease; D003251:Constriction, Pathologic; D005260:Female; D006083:Graft Occlusion, Vascular / Q000209:etiology; D006801:Humans; D007674:Kidney Diseases / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009018:Morocco; D006435:Renal Dialysis; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013927:Thrombosis / Q000209:etiology; D013997:Time Factors; D016896:Treatment Outcome; D014654:Vascular Patency