Complications of Arteriovenous Fistulas in Chronic Hemodialysis Patients in Niamey: Monitoring and Management at the HNABD Nephrology Department

Abstract

Introduction: The arteriovenous fistula (AVF) is the vascular approach of choice for chronic hemodialysis, due to its durability and low morbidity and mortality. However, it remains exposed to numerous complications that can compromise its proper functioning. Objective: To describe the complications of AVFs and evaluate their management in chronic haemodialysis patients in the nephrology department of the Hôpital National Amirou Boubacar Diallo in Niamey. Methodology: Prospective, descriptive and analytical study conducted from August 2023 to July 2024. Chronic hemodialysis patients with AVF were included. Doppler ultrasound and clinical evaluation were performed. Statistical analysis was performed with SPSS 25.0 and Epi Info 7.2.5.0. Results: Of 126 patients included (mean age: 46 years, sex ratio M/F = 1.93), 42.86% presented with an AVF complication. False aneurysm was the main complication (46.3%), followed by primary failure (22.2%) and thrombosis (18.5%). Management was mainly by medication in 92.3% of cases, but the outcome was favorable in only 38.5%. Several risk factors were identified, including anemia, female gender and prolonged AVF lifespan. Conclusion: Complications of AVFs are frequent in Niamey, with a predominance of false aneurysms. Early detection by Doppler ultrasound and a multidisciplinary approach are essential to improve patient management and prognosis.