title: Outcomes of arteriovenous fistula for hemodialysis in Sudanese patients: single-center experience.
abstract: A well-functioning arteriovenous fistula (AVF) is essential for the maintenance of hemodialysis (HD) in patients with chronic renal failure. Our aim is to review our experience of creating AVF and to asses its success rate and common complication. A prospective, hospital-based study was conducted on 73 patients (48 males and 25 females) on chronic HD in Gezira Hospital for Renal Diseases and Surgery, from January to July 2007. Their mean age was 43.9 years (range from 18 to 72 years). Seventy-one (97.3%) of the study subjects had been dialyzed before creation of the AVF, 67 (91.8%) of them having undergone HD with temporary access. All patients (n=73) had a native AVF as the permanent vascular access (VA). A primary radiocephalic AVF was created in 78.1% of the patients, cubital fossa in 20.5% and one case had left snuff box AVF (1.4%). Percentage of AVF maturation was reported in 67.1% of the cases within the first six weeks and in 9.6% of the cases AVF never matured. Failure of AVF function occurred in 26% of the cases, due to thrombosis in 20.5% (n=15) and aneurysm in 5.5% of the cases. We conclude that an optimum outcome is likely when there is a multidisciplinary team approach, and early referral to vascular surgery is paramount.
authors.affiliation: Department of Surgery, Faculty of Medicine, University of Gezira, Gezira, Sudan.
authors.forename: Gamal Mustafa
authors.initials: GM
authors.lastname: Ahmed
authors.forename: Mustafa Omran
authors.initials: MO
authors.lastname: Mansour
authors.forename: Mohamed
authors.initials: M
authors.lastname: Elfatih
authors.forename: Khalid Eltahir
authors.initials: KE
authors.lastname: Khalid
authors.forename: Mohammed El Imam Mohammed
authors.initials: Mel I
authors.lastname: Ahmed
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001166:Arteriovenous Shunt, Surgical / Q000009:adverse effects; D016009:Chi-Square Distribution; D002648:Child; D005260:Female; D006785:Hospitals, University; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010348:Patient Care Team; D011446:Prospective Studies; D012017:Referral and Consultation; D006435:Renal Dialysis; D013397:Sudan; D013997:Time Factors; D016896:Treatment Outcome; D034941:Upper Extremity / Q000098:blood supply*; D014654:Vascular Patency; D055815:Young Adult