The Relationship between the Blood Flow Volume of the Arteriovenous Fistula and its Early Effect on the Pulmonary Artery Pressure and the Left Ventricular Dimensions and Functions

Abstract

ardiovascular complications are leading cause of the death in hemodialysis patients. One of these complications is pulmonary hypertension which complicates chronic renal failure in 12–45% of cases, and causes an increase in all-cause mortality of 2-3 folds in the dialysis population. Nevertheless, the presence of an A-V fistula has been identified as an independent risk factor for developing pulmonary hypertension in End Stage Renal Disease (ESRD) patients. Although some authors assume that cardiac failure in chronic renal failure patients with A-V fistula occurs only in individuals with previously established chronic cardiac conditions, there is evidence that A-V fistula creation is a major risk factor for developing a new onset Congestive Heart Failure. Recent studies have used echocardiography to assess cardiac dimensions and functions before and after arteriovenous fistula creation. Different study styles were used including cross-sectional, Cohort prospective and retrospective studies to assess the relation and effects of AVF creation on cardiac dimensions and functions. Cross-sectional studies were done just to prove high flow fistulas effects on the heart, whereas cohort studies were used to follow up cardiac dimensions and functions after fistula creation and sometimes after fistula closure in patients who underwent kidney transplantation.