title: Retrospective review of arteriovenous fistula success rate in a multi-ethnic Asian population.
abstract: BACKGROUND
  Native vein arteriovenous fistulas (AVFs) are the recommended first-line vascular access in hemodialysis patients. Despite this, AVFs are plagued with unfavorable maturation rates. We conducted a retrospective cohort study to assess the AVF success rate and to identify any significant associating factors.
  
  
  METHODS
  Demographic and clinical data of all AVFs created from January 2011 to June 2013 at a single center with a multi-ethnic Asian population, were reviewed. The primary outcome was AVF successfully used for hemodialysis (FUSH) at 6 months. Secondary endpoints were the overall FUSH and actual maturation time of the AVFs. Univariate and multivariate analyses were performed to identify factors associated with AVF success.
  
  
  RESULTS
  A total of 375 fistulas were created during the study period (110 radiocephalic, 176 brachiocephalic, 89 brachiobasilic). The mean age was 59.4 ± 12.6 years and 42.9% were females. Seventy-one percent of patients had diabetes, 32.5% had ischemic heart disease and 10.7% had peripheral vascular disease. 246/375 (65.6%) AVFs FUSH by 6 months, and the average AVF maturation time was 16.1 ± 10.7 weeks. Of the 246 AVFs, 11% required secondary procedure to assist their success. Univariate analysis showed that gender (p = 0.035), age (p = 0.018), vein size on pre-operative vein mapping (p = 0.004) and operating surgeon (p = 0.021) were significant factors associated with AVF success. On multivariate analysis, age, pre-operative vein size and operating surgeon were significantly associated with fistula success.
  
  
  CONCLUSIONS
  Reasonable FUSH rates can be achieved in the study patients. Patient age, pre-operative vein mapping size and operating surgeon were shown to influence AVF success rate.
authors.affiliation: Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore - Singapore.
authors.forename: Kyi Z
authors.initials: KZ
authors.lastname: Thant
authors.affiliation: Yong Loo Lin School of Medicine, National University of Singapore - Singapore.
authors.forename: Kevin
authors.initials: K
authors.lastname: Quah
authors.affiliation: Department of Urology, National University Health System - Singapore.
authors.forename: Tze K
authors.initials: TK
authors.lastname: Ng
authors.affiliation: Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore - Singapore.|Department of Cardiac, Thoracic and Vascular Surgery, National University Health System - Singapore.
authors.forename: Pei
authors.initials: P
authors.lastname: Ho
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001166:Arteriovenous Shunt, Surgical / Q000009:adverse effects; D044466:Asian People; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010690:Phlebography; D006435:Renal Dialysis; D012189:Retrospective Studies; D012307:Risk Factors; D012846:Singapore / Q000453:epidemiology; D066231:Surgeons; D013997:Time Factors; D016896:Treatment Outcome; D018616:Ultrasonography, Doppler, Duplex; D034941:Upper Extremity / Q000098:blood supply*; D014654:Vascular Patency; D014680:Veins / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D055815:Young Adult