Predictors of successful arteriovenous fistula maturation

Feldman, Harold I.; Joffe, Marshall M.; Rosas, Sylvia E.; Burns, James C.; Knauss, Jill; Brayman, Kenneth L.

doi:10.1016/j.ajkd.2003.07.003

Cited by 198 publications

(152 citation statements)

References 28 publications

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“…Both our data and the observations of Feldman et al (13) are in keeping with the notion that the ultimate predictor of primary fistula success is likely the vessel size. In addition to previous reports, Feldman and colleagues (13,21) demonstrated that vessels Ͼ3 mm in diameter are associated with higher rates of primary fistula success.…”

Section: Discussionsupporting

confidence: 76%

“…In addition to previous reports, Feldman and colleagues (13,21) demonstrated that vessels Ͼ3 mm in diameter are associated with higher rates of primary fistula success. Although Feldman et al reported that a history of cerebrovascular disease and cardiovascular disease, increasing age, and dependence on dialysis at the time of fistula creation predicted primary fistula success, it should be noted that whether to attempt an AVF in the study by Feldman et al was not based on vessel size measurement (as it was in our study for surgeons who used approach 1).…”

Section: Discussionmentioning

confidence: 99%

“…For instance, Miller et al (10) reported higher primary fistula failure rate in older and female patients with diabetes, although small numbers and a highly selected patient population limit the generalizability of these results. Feldman et al (13) published data from a larger cohort (348 patients), reporting a primary success rate of 54%. Preexisting cerebrovascular disease, older age, and commencement of dialysis before access creation were noted to be associated with higher primary fistula failure in their study.…”

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confidence: 99%

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Comorbidities Do not Influence Primary Fistula Success in Incident Hemodialysis Patients

Wang¹,

Murphy²,

Yılmaz³

et al. 2008

Clinical Journal of the American Society of Nephrology

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Background and objectives: Concern about primary fistula failure may contribute to the underuse of arteriovenous fistula. The objective of this study was to investigate the baseline clinical parameters associated with primary fistula success.Design, setting, participants, & measurements: Consecutive incident patients who commenced dialysis during a 28-mo period in a regional renal program were studied. Data on patient-related variables and on surgical approach (e.g., whether the surgeons routinely assess vessel size during the operation) were collected. Primary fistula success was defined as an arteriovenous fistula that was able to afford successful dialysis for 3 h with blood pump speed of >300 ml/min for three consecutive sessions.Results: A total of 205 (69%) patients had an AVF attempted as their first vascular access. The overall primary success rate was 64% and was similar for radiocephalic and brachiocephalic fistula. Logistic regression was done separately for patients with the two types of fistula because of the presence of statistical interaction. For radiocephalic fistula, male gender was the only parameter associated with primary fistula success (odds ratio 3.57; P ‫؍‬ 0.01). The presence of comorbidity was not significantly associated with primary fistula failure.Conclusions: Despite significant patient comorbidity, there was a high primary fistula success rate among this incident hemodialysis cohort. Given that vessel size may be the ultimate determinant of fistula success, if surgeons assess vessel size perioperatively, then the presence of significant comorbidity might not preclude arteriovenous fistula from being attempted as the initial access.

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Section: Discussionsupporting

confidence: 76%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Comorbidities Do not Influence Primary Fistula Success in Incident Hemodialysis Patients

Wang¹,

Murphy²,

Yılmaz³

et al. 2008

Clinical Journal of the American Society of Nephrology

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“…Primary failure of fistulas (as a result of thrombosis or failure of maturation into a functional access) used to range from 10 to 20% 6,13 but more recently is reported two to four times higher, in the 40 to 45% range. 6,19,20 In fact, a recent prospective, 11-center European study reported an unexpectedly high primary failure rate of 40%. 21 In this study, patency rates (access survival from creation) and potential risk factors that affect functional patency (survival from first dialysis use) were examined.…”

mentioning

confidence: 99%

Resolved

Besarab¹

2008

Journal of the American Society of Nephrology

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“…Nonmaturation in study by Feldman et al of 348 HD patients found was associated with a history of stroke, transient ischaemic attack, increasing age and dependence on dialysis when the fistula was created [39]. However, a study by Lee et al evaluated factors affecting cumulative access survival of AVF; they reported that age, race, diabetes, gender and peripheral vascular disease did not show significant association with access survival, with the only predictor of poor outcome being the number of salvage procedures; the higher number of secondary interventions required, the less likely for the fistula to last for a long period [25].…”

Section: Discussionmentioning

confidence: 99%