Vol. 6 (10) pp. 409-412 DOI: 10.21474/IJAR01/7825

FACTORS INFLUENCING EARLY PRIMARY PATENCY OF AV FISTULA IN PEDIATRIC PATIENTS WITH CHRONIC KIDNEY DISEASE.

6 Downloads 53 Views
Crossref

Abstract

Background: Arteriovenous fistulae (AVF) are the dialysis access modality of choice for patients with end stage renal disease (ESRD). The longer maturation time in children than that in adults and the technical difficulties imposed by small diameters of the vessels are other reasons for a reluctance to create AVFs in children. Methods: Data abstracted included age, weight, sex, etiology of renal failure, time on dialysis, CVC history, and transplantation history. Patients of age 0 to 15 were included in this study, age was the only inclusion criteria. Results: Pre operative and prior vene puncture was present in (80%) patients with primary failure. Greater than 1 previous access failure strong predictor of failure. Surprisingly absence of prior HD was favoring early failure. Intraoperatively poor vein distension( <2mm) and post operative Doppler showing absence of spiral laminar flow also predicted early failure in 100% of the patients. Conclusion: anatomic factors like vein distension, prior venepuncture highly influence the patency rates. anemia, hypertension and HD benefitted in maintaining patency. proper education of the medical fraternity dealing with peadiatric renal failure patients regarding these factor will help in long term functioning of the fistulas and survival.

Article Analytics

References

  1. Fogarty D, Cullen R: UK Renal Registry 16th Annual Report. Renal Association [Acceesed online on 12th November 2014: https://www.renalreg. org/wp-content/uploads/2014/09/00a-Introduction.pdf]
  2. National Kidney Foundation: KDOQI clinical practice guidelines and clinical practice recommendations for 2006 updates: haemodialysisadequacy, peritoneal dialysis adequacy and vascular access. Am J Kidney Dis 2010, 56:566?577.
  3. Thomson PC, Stirling CM, Geddes CC, Morris ST, Mactier RA: Vascular access in haemodialysis patients: a modifiable risk factor for bacteraemia and death. QJM 2007, 100(7):415?422.
  4. Bray BD, Boyd J, Daly C, Donaldson K, Doyle A, Fox JG, Innes A, Khan I, Peel RK, Severn A, Shilliday I, Simpson K, Stewart GA, Traynor J, Metcalfe W: Vascular access type and risk of mortality in a national prospective cohort of haemodialysis patients. QJM 2012, 105(11):1097.
  5. Fluck R, Kumwenda M: Clinical Practice Guidelines: Vascular Access for Haemodialysis, The Renal Association 5th ed. 2011.
  6. Ramage IJ, Bailie A, Tyerman KS, McColl JH, Pollard SG, Fitzpatrick MM. Vascular access sur vival in children and young adults receiving long-term hemodialysis. Am J Kidney Dis 2005;45:708-714.
  7. Fadrowski JJ, Hwang W, Neu AM, Fivush BA, Furth SL. Patterns of use of vascular catheters for hemodialysis in children in the United States. Am J Kidney Dis 2009;53:91-98.
  8. Hayes WN, Watson AR, Callaghan N, Wright E, Stefanidis CJ; European Pediatric Dialysis Working Group. Vascular access: choice and complications in European paediatric haemodialysis units. Pediatr Nephrol 2012; 27:999-1004.
  9. Sidawy AN, Gray R, Besarab A, Henry M, Ascher E, Silva M Jr, et al. Recommended standards for reports dealing with arteriovenous hemodialysis accesses. J Vasc Surg 2002;35: 603-610.
  10. Bagolan P, Spagnoli A, Ciprandi G, Picca S, Leozappa G, Nahom A, et al. A ten-year experience of Brescia-Cimino arteriovenous f istula in children: technical evolution and refinements. J Vasc Surg 1998;27:640-644.
  11. Briones L, Diaz Moreno A, Sierre S, Lopez L, Lipsich J, Adragna M. Permanent vascular access survival in children on long-term chronic hemodialysis. Pediatr Nephrol 2010;25:1731- 1738.
  12. Sheth RD, Brandt ML, Brewer ED, Nuchtern JG, Kale AS, Goldstein SL. Permanent hemodialysis vascular access survival in children and adolescents with end-stage renal disease. Kidney Int 2002;62:1864-1869.
  13. Gradman WS, Lerner G, Mentser M, Rodriguez H, Kamil ES. Experience with autogenous arteriovenous access for hemodialysis in children and adolescents. Ann Vasc Surg 2005;19:609- 612.
  14. War tman SM, Rosen D, Woo K, Gradman WS, Weaver FA, Rowe V. Outcomes with arteriovenous fistulas in a pediatric population. J Vasc Surg 2014;60:170-174.
  15. Chand DH, Bednarz D, Eagleton M, Krajewski L. A vascular access team can increase AV fistula creation in pediatric ESRD patients: a single center experience. Semin Dial 2009; 22:679-683.
  16. Manook M, Calder F. Practical aspects of arteriovenous fistula formation in the pediatric population. Pediatr Nephrol 2013;28:885-893.
  17. Son HJ, Min SK, Min SI, Park YJ, Ha J, Kim SJ. Evaluation of the efficacy of the forearm basilic vein transposition arteriovenous fistula. J Vasc Surg 2010;51:667-672.
  18. Korean Network for Organ Sharing (KONOS). 2014 KONOS Annual Report [Internet]. Seoul: KONOS; 2015 [cited 2015 Sep 15]. Availabe from: https:// www.konos.go.kr.
  19. Bourquelot P, Cussenot O, Corbi P, Pillion G, Gagnadoux MF, Bensman A, et al. Microsurgical creation and follow-up of arteriovenous fistulae for chronic haemodialysis in children. Pediatr Nephrol 1990;4:156-159.
  20. Sanabia J, Polo JR, Morales MD, Canals MJ, Polo J, Serantes A. Microsurgery in gaining paediatric vascular access for haemodialysis. Microsurgery 1993;14:276-279.
  21. Wong CS, McNicholas N, Healy D, Clarke-Moloney M, Coffey JC, Grace PA, et al. A systematic review of preoperative duplex ultrasonography and arteriovenous fistula formation. J Vasc Surg 2013;57:1129-1133.

How to Cite This Article

M. Bakthavatchalam, Sasikumar Sakthivelan and Jayakrishnan Ramakrishnan. (2018); FACTORS INFLUENCING EARLY PRIMARY PATENCY OF AV FISTULA IN PEDIATRIC PATIENTS WITH CHRONIC KIDNEY DISEASE., Int. J. of Adv. Res., 6 (10), 409-412, ISSN 2320-5407. DOI: https://doi.org/10.21474/IJAR01/7825

Corresponding Author

SASIKUMAR SAKTHIVELAN