Role of Monitoring and Surveillance for Hemodialysis Vascular Access

Abstract

Introduction: Vascular access complications are of great burden in the chronic hemodialysis population. Morbidity related to vascular access is the leading cause of frequent hospitalization among chronic hemodialysis patients and is associated with huge problems. Aim: to report vascular access dysfunction and complications in 100 chronic hemodialysis patients who were receiving their treatment at Kafr EL Sheik General Hospital Dialysis Unit – Ministry of Health. Patients and methods: 100 chronic hemodialysis patients who were receiving their treatment at Kafr EL Sheik General Hospital Dialysis Unit – Ministry of Health were enrolled in this study; they had a native arteriovenous fistula and were prevalent hemodialysis patients. They were divided into 3 groups low flow group I (24 patients) had estimated arteriovenous fistula blood flow less than 800 ml / min, moderate flow group II: (38 patients) had estimated arteriovenous fistula blood flow from 801 to 1600 ml / min and high flow group III: ( 38) patients had estimated arteriovenous fistula blood flow greater than 1600 ml / min. Results: Prevalence of different complications recorded in patients was 25% arm swelling, 24% difficult canulation, 20% Prolonged Bleeding, 8% Signs of inflammation and infection, 79 % Aneurysm/pseudo –aneurysm, 6% Impending rupture, 26% Signs of steal, 4% Thrombosis and 7% stenosis. The majority of our results confirmed superiority of moderate and high flow groups (group I & II) concerning most of the measured parameters and less in complications.