Vascular access for haemodialysis in Ghana: a single centre experience

INTRODUCTION: Vascular access (VA) and its maintenance is of optimum priority in haemodialysis patients. A retrospective cohort analysis was performed to evaluate the types of vascular access used by patients on haemodialysis at the dialysis unit of a teaching hospital in Ghana. METHODS: a cross-sectional retrospective analysis of 80 patients’ data on haemodialysis at the renal clinic of a Teaching hospital was performed. The sociodemographic and clinical data were obtained, organized and analyzed with Statistical Package for the Social Sciences (SPSS). RESULTS: a total of 80 participants were studied, 65% being males and over 50% of them being ≥ 45 years with (87.8%) being married. Among the 35.5% who had been on dialysis for less than 3 months, 85.2% were using temporary venous access (TVA), with 14.8% using tunneled venous access (TUV). However, for those on dialysis for more than a year (32.9%), 12% were using TVA, 52% having arteriovenous fistula (AVF) with 36% using TUV. The commonest venous access used for rural dwellers was temporary venous access constituting 76.9% with majority of urban dwellers using the arteriovenous fistula (80.0%). The dominant access vein was the internal jugular vein forming 80.5%. All the AKI and majority of the AKI/CKD patients (73.9%) had TVA. Majority (40.3%) of the ESRD patients also had TVA. Although there was no significant association between sociodemographic data and type of vascular access, we found a significant association between diagnosis, duration of dialysis and type of vascular access. CONCLUSION: temporary vascular access is the commonest vascular access for most patients on chronic haemodialysis in our centre. This is followed by arteriovenous fistula and tunneled vascular access.