Effect Of Proximal Versus Distal Arteriovenous Fistula On Cardiac Function in Hemodialysis Patients

Abstract

ABSTRACT Background and aims: Cardiovascular disease (CVD) is the leading cause of morbidity and mortality in patients with End-Stage Renal Disease (ESRD). It accounts for half of the deaths and one-third of hospitalizations of dialysis patients. One of the common treatment options of patients suffering from end-stage renal disease is hemodialysis. Hemodialysis is usually done through a vascular access route, ie, arteriovenous fistula (AVF). Arteriovenous fistula is a nonphysiologic vascular access which is imposed on cardiovascular system. Arteriovenous fistula decreases systemic vascular resistance, causing increased stroke volume and cardiac output in order to maintain blood pressure, and this can cause left ventricular volume overload and eccentric left ventricular hypertrophy. Although the chronic volume overload caused by AVF induces structural and functional changes on cardiovascular system, whether these changes increase mortality and morbidity in patients is unclear. This was aimed at assessment the effect of proximal and distal primary native AVF flow on cardiac function in hemodialysis patients.