Hemodialysis access operations performed upon patients with human immunodeficiency virus

Hemodialysis in known patients infected with human immunodeficiency virus (HIV) has been a subject of controversy. During a 60 month period, 28 hemodialysis access operations were performed upon 22 HIV infected patients. The indication for all procedures was need of dialysis access secondary to end-stage renal failure (ESRF). Operations included 24 arteriovenous dialysis grafts and four Cimino arteriovenous fistulas. All patients had a diagnosis of acquired immunodeficiency syndrome (AIDS) (five), AIDS related complex (six) or were HIV-positive (11) at the time of the operations. All of these patients were intravenous drug abusers. Follow-up study ranged from nine days to 13 months. During the course of this study, two patients died of the progression of AIDS for a mortality rate of 9 per cent. There were nine perioperative complications for a rate of 32 per cent. These results led us to conclude that hemodialysis access operations have application in HIV infected patients with ESRF, and hemodialysis should be considered an appropriate modality in those patients requiring long term dialysis.