title: [Emergency vascular access conversion to native arterio veinous fistula: a prospective study of 37 hemodialysis patients in Rwanda].
abstract: Chronic hemodialysis in Rwanda is relatively recent and most of patients are treated with catheters.
  
  
  CONCLUSIONS
  Thirty-seven patients who require chronic hemodialysis with catheters were evaluated during a 3-years period in order to facilitate the creation of a permanent vascular access for hemodialysis (AVF). Patient selection were made during a multi-disciplinary consultation. The sex-ratio was 1.5 and the main cause of the nephropathy was arterial hypertension.
  
  
  RESULTS
  Thirty-one patients benefited from the creation of an arterioveinous fistula. All of the interventions were performed using local or loco-regional anesthesia. Sixty percent of these AVF were radio-cephalic, 35.4% were humero-cephalic. Sixty-four percent of the operations were performed on ambulatory patients, with a primary function for 90% of them.
  
  
  CONCLUSIONS
  This work proves the feasibility of the creation of AVF in Rwanda, thus allowing to preclude the various complications that arise with the prolonged use of a catheter. This experience was made possible by the pooling of the resources of 4 of Rwanda's leading hospitals. In an early future, the development of vascular surgery will assure the permanence of this care.
authors.affiliation: Service de néphrologie-hémodialyse, clinique Sainte-Anne, 182, route de la Wantzenau, 67085 Strasbourg cedex, France. Electronic address: kolbi4@wanadoo.fr.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Kolb
authors.affiliation: Service d'anesthésie-réanimation, centre hospitalier universitaire de Butare, Province-du-Sud BP 254, Butare, Rwanda.
authors.forename: Théogène
authors.initials: T
authors.lastname: Twagirumugabe
authors.affiliation: Service de chirurgie générale, centre hospitalier universitaire de Kigali, boulevard de la Paix, Kigali, Rwanda.
authors.forename: Innocent
authors.initials: I
authors.lastname: Uyisabye
authors.affiliation: Service d'anesthésie-réanimation, hôpital militaire de Kanombe, Kicukiro 23, Kigali, Rwanda.
authors.forename: Jérôme
authors.initials: J
authors.lastname: Muhizi
authors.affiliation: Service de néphrologie-hémodialyse, centre hospitalier universitaire de Strasbourg, 1, place de l'Hôpital, 67000 Strasbourg, France.
authors.forename: Laura
authors.initials: L
authors.lastname: Braun-Parvez
authors.affiliation: Service de néphrologie-hémodialyse, clinique Sainte-Anne, 182, route de la Wantzenau, 67085 Strasbourg cedex, France.
authors.forename: Sarah
authors.initials: S
authors.lastname: Richter
authors.affiliation: Service d'hémodialyse, King Faisal hospital, PO box 2534, Kigali, Rwanda.
authors.forename: Joseph
authors.initials: J
authors.lastname: Ntarindwa
authors.affiliation: Service d'hémodialyse, centre hospitalier universitaire de Butare, Province-du-Sud BP 254, Butare, Rwanda.
authors.forename: Jean-de-Dieu
authors.initials: JD
authors.lastname: Nzambaza
authors.affiliation: Service d'hémodialyse, centre hospitalier universitaire de Butare, Province-du-Sud BP 254, Butare, Rwanda.
authors.forename: Richard
authors.initials: R
authors.lastname: Rwandenzi
authors.affiliation: Service d'hémodialyse, King Faisal hospital, PO box 2534, Kigali, Rwanda.
authors.forename: Martine
authors.initials: M
authors.lastname: Kibuka
authors.affiliation: Service de chirurgie vasculaire, clinique de l'Orangerie, 29, allée de la Robertsau, 67000 Strasbourg, France.
authors.forename: Françoise
authors.initials: F
authors.lastname: Mantz
mesh_terms: D000328:Adult; D000553:Ambulatory Care; D000772:Anesthesia, Local; D001132:Arm / Q000098:blood supply; D001166:Arteriovenous Shunt, Surgical; D055499:Catheter-Related Infections / Q000209:etiology; D015897:Comorbidity; D004630:Emergencies; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000209:etiology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D010530:Peritoneal Dialysis; D011446:Prospective Studies; D006435:Renal Dialysis; D012432:Rwanda; D016896:Treatment Outcome; D062666:Vascular Access Devices / Q000009:adverse effects
keywords: Africa; Afrique sub-saharienne; Arterioveinous fistula; Catheter; Cathéter; Chronic kidney disease; Fistule artério-veineuse; Hemodialysis; Hémodialyse; Insuffisance rénale chronique; Rwanda