Predictors of AV fistula adequacy in haemodialysed patients

INTRODUCTION: Vascular access failure remains a significant problem in haemodialysis. Complications of dialysis access represent major cause of morbidity in dialysis patients. The aim of our study was to correlate the AV-fistula adequacy with clinical and demographic factors. MATERIAL AND METHODS: The survey encompassed 40 patients followed up in one-year period. AV-fistula adequacy was graded if the blood flow rate was higher or equal to 300 ml/ min. AV-fistula adequacy was correlated with clinical and demographic factors. Following data were gathered: age, gender, diabetic status, body mass index (BMI), serum parathyroid hormone (PTH), and serum albumin. RESULTS: The study included 40 patients (25 males and 15 females), average age of 46.3 +/- 12.65 years and haemodialysis duration of 3.16 +/- 2.39 years. 40% of AV-fistulas were created in patients older then 65 years. Diabetes was present in 30% of patients. 45% of patients were overweighed (BMI > or = 27 kg/m2). The mean concentration of intact PTH was 418.867 +/- 320.44. Serum PTH was higher then 500 pg/mol in 35% of patients. The mean serum albumin concentration was 40.129 +/- 3.509 g/l. AV-fistula adequacy was lower in older patients (age > or = 65) then in younger patients (age or = 27 kg/m2 was statistically highly significant (p < 0.001). Lower overweighed patients had better AV-fistula adequacy. Serum albumin, as well as the PTH level did not influence AV-fistula adequacy, while age and BMI significantly correlated with AV-fistula adequacy. CONCLUSION: Predictors of AV-fistula malfunction in our dialysis population were age, diabetes and overweight, while other clinical and demographical factors did not influence AV-fistula adequacy.