Journal Article

Obesity is not an obstacle for successful autogenous arteriovenous fistula creation in haemodialysis

Waclaw Weyde, Magdalena Krajewska, Waldemar Letachowicz, Tomasz Porazko, Ewa Watorek, Mariusz Kusztal, Miroslaw Banasik, Tomasz Gołebiowski, Hanna Bartosik, Katarzyna Madziarska, Dariusz Janczak and Marian Klinger

in Nephrology Dialysis Transplantation

Published on behalf of European Renal Association - European Dialysis and Transplant Assoc

Volume 23, issue 4, pages 1318-1322
Published in print April 2008 | ISSN: 0931-0509
Published online October 2007 | e-ISSN: 1460-2385 | DOI: http://dx.doi.org/10.1093/ndt/gfm739
Obesity is not an obstacle for successful autogenous arteriovenous fistula creation in haemodialysis

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Background. Obesity, which is often associated with diabetes, is increasingly encountered in the haemodialysed population, and this may produce difficulty in autogenous arteriovenous fistula creation. Prosthetic angioaccess or catheters, when used in place of autogenous fistulas, increase thrombotic and infectious complications in these already challenged patients.

Methods. This prospective study was undertaken to assess the feasibility of autogenous arteriovenous fistula creation in 71 obese patients (BMI 34.6 ± 7.8). We performed a two-stage procedure, in which radio-cephalic fistula formation was followed by subcutaneous transposition of the venous component for safe and easy puncture.

Results. Fistulas suitable for puncture, having blood flows of 799 ± 285 ml/min, and sufficient to perform adequate haemodialysis (Kt/V 1.24) were achieved in 85% of the patients. Primary patency rates were 65% and 59% at 6 and 12 months, respectively, and secondary patency rates were 83% both at 6 and 12 months.

Conclusions. Obesity does not prevent successful autogenous arteriovenous fistula formation, and may protect forearm venous vessels from the iatrogenic damage that occurs before the onset of haemodialysis therapy.

Keywords: autogenous fistula; obesity; radio-cephalic fistula; transposition; vascular access

Journal Article.  2361 words.  Illustrated.

Subjects: Nephrology

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