The cost of arteriovenous fistula placement in patients with chronic end-stage renal disease in Ouagadougou (Burkina Faso) 2020

Abstract

End-stage renal disease (ESRD) is a late diagnosis. Its prevalence is rapidly increasing worldwide. Although various management techniques exist, they all require access routes. The arteriovenous fistula (AVF) is the vascular access of choice for regular and prolonged hemodialysis sessions. Studies have shown that an AVF saves patients money. In our context, we found no data in the literature on the cost of AVF and the lump-sum cost. The aim of this study was to determine the average costs of AVF and lump-sum costs, and to describe patients' coping strategies in relation to these costs. Methods We conducted a cross-sectional study in the three public hemodialysis units of the city of Ouagadougou, Burkina Faso. Hemodialysis patients suffering from chronic renal failure, hospitalized or not, minors or adults having given their consent (assent) were included in the study. Results A total of 290 patients ranging in age from 12 to 82 years participated in the study. Almost half the patients (47.5%) had no income. More than half the patients had undergone fistula repair privately. Hypertension and diabetes were the pathologies most frequently associated with end- stage renal disease in this study, with 77% and 16.90% respectively. The average cost of a fistula was 260,798 Fcfa, while the average cost of a package was 506,459 Fcfa. To cope with these costs, some patients resorted to selling goods (means of subsistence) in 4.83%, borrowing, bartering and others begging. Conclusion The average cost of arteriovenous fistula and the fixed fee for haemodialysis remain an economic barrier for patients and families to haemodialysis in Burkina Faso. More than half of all patients have their fistulas done in the private sector, which costs twice as much as the public sector. Training providers working in public haemodialysis units to perform arteriovenous fistula is necessary to reduce this cost for patients.