Vascular Access Outcomes among Patients on Maintenance Hemodialysis in Perpetual Succour Hospital: A 3-Year Cross-Sectional Analysis

Abstract

Introduction : Vascular access is the key to the successful management of chronic hemodialysis (HD) patients. Though native arteriovenous fistula (AVF) is considered the access of choice, many patients in our country initiate hemodialysis through the central venous catheter (CVC). Hence, successful HD depends on the creation and maintenance of adequate vascular access. Methods : A single-center, cross-sectional study of ESRD patients on maintenance hemodialysis enrolled in Perpetual Succour Hospital Hemodialysis Unit from April 1, 2021, to November 30, 2023, was employed so that vascular access outcomes of patients on maintenance hemodialysis were determined. Results. There were 260 hemodialysis patients included, with successful vascular access outcomes (73.13%) and were younger (57.2 ± 14.1). Those who had failed vascular access were females (54.2%), unemployed (61.4%) and had diabetes mellitus (50.6%) as the primary etiology of their ESRD. Those with failed vascular access were hypertensive (86.7%), with a history of CAD and MI (57.8%) and had diabetes mellitus (56.6%). The proportion of those with failed and successful vascular access significantly differs among hypertensives (p = 0.012), diabetics (p = 0.039), with chronic glomerulonephritis (p = 0.011), and those with malignancy (p = 0.003). Conclusion : In precis, the type of access, interventions carried out, and vascular access site significantly vary between HD patients with unsuccessful vascular access results and those who were successful. Patients with unsuccessful results despite treatment were those who switched to CVC, while most of those with successful vascular outcomes did not change. Reasons for changing vascular access were due to an absence of bruit and the main reason for those with failed access. Successful vascular access outcomes are significant in younger patients, and failed vascular access is mostly observed in unemployed females with diabetes mellitus.