One-Year Patency Rate of Arteriovenous Fistula and its Predicting Factors in Patients with Chronic Renal Failure

Background and Development of arteriovenous fistulas (AVF) is one of the major advances in the management of patients undergoing hemodialysis. Patency rate of these fistulas and the factors influencing them is of great importance to reduce the costs and rate of repeated hospitalization. In a five-year study 72 patients who had native AVF were followed for one year. Function time of each fistula, site, type of anastomosis, age, sex, history of diabetes, hypertension, temporary catheter for dialysis, and duration of renal failure (RF) were determined. One- year patency rate of AVF was 80.6% which was found significantly lower among those aged more than 65 years, cases with history of RF more than 20 months, and among patients who had wrist fistulas (P=0.001, 0.002, 0.031, respectively). However, the patency rate was not affected by other factors. Because of high patency rate, native AVF is yet the best way of vascular access for repeated hemodialysis. To achieve an optimal outcome with AVF we recommend placing them preferentially in the upper arm in those older than 65 years of age and in patients with prolonged history of RF. In addition, patients with chronic RF must be selected for this operation earlier in the course of their disease.