Mid-Term Outcome of Arteriovenous Fistula in Paediatric Patients With End-Stage Renal Disease: a Single Centre Experience

Abstract

The aim of the study was to evaluate the patency rates of arteriovenous fistula (AVF) in paediatric patients with end-stage renal disease (ESRD) in the mid-term. The study was conducted retrospectively. The medical archive was searched between January 2015 and February 2018. A total of 26 patients comprised the study population. The median age and weight of the patients at the time of AVF creation were 13.2 years (IQR = 11.9 – 15.6 years) and 41.5 kg (34.8 – 50.5 kg), respectively. Eight (69.2%) patents were male. The AVF created was radio-cephalic in 21 (80.8%) and brachial-level in five (19.2%) patients; brachio-cephalic in 3 and brachio-basilic in 2 patients. The patients with a radial-level AVF were younger (p = 0.001), and their body weights were lower (p<0.001). In patients with radio-cephalic AVF, analysis of age (rs =-0.48, p = 0.028) and weight (rs =-0.56, p = 0.008) revealed a negative correlation with duration of AVF maturation. The duration of follow-up was 21.2 months (IQR = 14.5 – 28.3 months). While the primary rates at 1 and 2 years were 92.3% and 84.6%, the secondary patency rates were 96.2% and 92.3%, respectively. Our results showed that AVF is the most suitable and durable renal replacement therapy in patients with ESRD. The weight and level of AVF have a considerable influence on the duration of AVF maturation. In summary, AVF still remains the procedure of choice in regions where the paediatric kidney transplantation programmes are not completely set up that have resultant long transplantation waiting periods. © 2019, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.