title: Complications of arteriovenous fistula for hemodialysis: an 8-year study.
abstract: BACKGROUND
  To assess the frequency and characteristics of complications of arteriovenous fistula (AVF) and their effect on fistula outcome.
  
  
  METHODS
  We retrospectively reviewed 628 AVFs constructed from November 2002 to October 2010 to record the complications and their management options. The association between age, sex, comorbidities (HIV, hypertension, and diabetes), fistula type, and complications was sought.
  
  
  RESULTS
  Most patients were males (73.7%). The mean age was 45.3 years. Comorbidities seen included diabetes mellitus (22.12%), hypertension (83.12%), and HIV infection (9.87%). AVFs constructed were mainly radiocephalic (68%) and brachiocephalic (24.9%). The median follow-up period was 275 days. The cumulative patency rate was 76% and 51% at 1 year and 2 years, respectively. Altogether, 211 complications occurred in 16% of the AVFs. Among them, 36.96% were severe, 25.11% moderate, and 43.91% minor. With respect to the time of occurrence, 63.98% were late complications, 12.79% immediate, and 23.22% early. Aneurysms, failure to mature, and thrombosis were the most frequent complications occurring in 26.54%, 14.69%, and 12.79% of cases, respectively. The management options for the complications included the creation of a new access in 36.96%, a temporary catheter before a new AVF in 10.52%, and nonoperative management in 43.12%. We found no adverse effect of comorbid factors such as diabetes mellitus (χ(2) = 3.58, P > 0.05) or HIV-positive status (χ(2) = 0.64, P > 0.05) on the complication rate.
  
  
  CONCLUSIONS
  This study shows an overall frequency of complications of 16%. These results show the potential for low complication rate of AVF in selected population.
authors.affiliation: Department of Surgery, Yaoundé General Hospital, Yaoundé, Cameroon. mfokou@yahoo.com
authors.forename: Marcus
authors.initials: M
authors.lastname: Fokou
authors.forename: Abel
authors.initials: A
authors.lastname: Teyang
authors.forename: Gloria
authors.initials: G
authors.lastname: Ashuntantang
authors.forename: Francois
authors.initials: F
authors.lastname: Kaze
authors.forename: Victor Claude
authors.initials: VC
authors.lastname: Eyenga
authors.forename: Alain
authors.initials: A
authors.lastname: Chichom Mefire
authors.forename: Fru
authors.initials: F
authors.lastname: Angwafo
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000783:Aneurysm / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D001166:Arteriovenous Shunt, Surgical / Q000009:adverse effects*; D002163:Cameroon / Q000453:epidemiology; D016009:Chi-Square Distribution; D015897:Comorbidity; D005260:Female; D006083:Graft Occlusion, Vascular / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy; D006435:Renal Dialysis; D012086:Reoperation; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013927:Thrombosis / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D013997:Time Factors; D016896:Treatment Outcome; D014654:Vascular Patency; D055815:Young Adult