Audit of Haemodialysis Vascular Access in a Sub-Saharan Tertiary Hospital

Abstract

BACKGROUND: Guidelines recommend using arteriovenous fistulas (AVFs) as the preferred vascular access route for haemodialysis patients. However, in resource-poor settings, establishment and maintenance of AVFs can be challenging. This research aims to audit the current practices and outcomes of vascular access routes for haemodialysis at Ekiti State University Teaching Hospital, Ado Ekiti, Nigeria, a tertiary hospital in sub-Saharan Africa. METHOD AND MATERIALS: This retrospective, descriptive analysis examines vascular access routes for haemodialysis at our dialysis centre over 11 years, utilising data collected from the medical records of patients who received haemodialysis RESULT: Among the 318 patients, males were more prevalent (61.3% vs. 38.7%). The average age was 49.7 years. Femoral catheters were most commonly used compared to other catheters. Catheter use lasted less than a month for two-thirds of patients (66.4%), while 24.8% used them beyond 6 months. Catheter-related infection (49.8%) was the most frequent complication followed by discomfort (25.8%). Discontinuation reasons included clinical improvement (especially in acute kidney injury patients, 52.0%), death (17.3%), transplantation (3.1%), bleeding (2.8%), and recurrent infection (6.0%). CONCLUSION: The implications of these findings are far-reaching, as suboptimal vascular access can negatively impact patient outcomes, quality of life, and the overall effectiveness of haemodialysis.