Effects of Comorbidities Due to AV Fistula Insufficiency on Fistula Blood Flow Rate in Hemodialysis Patients

INTRODUCTION and AIMS: Arteriovenous (AV) fistulas are the most frequently used blood vessel entrances in chronic hemodialysis patients. In this study the appropriateness of AV fistulas in 38 patients were evaluated and the association between the problematic fistulas which can not reach the required blood flow rate (BFR) of 350 mL/min, and the clinical and laboratory values of the patients were investigated.


METHODS: Thirty-eight hemodialysis patients (mean age 58 years [35-79 years], 26 males [%68.4], 12 females [% 31.6]) were included in the study. Patients were allocated according to their blood flow rate: Group 1 (<350 mL/min; n: 21) and Group 2 (>350 mL/min; n: 17). Groups were compared for their demographic, clinical and biochemical data, and localization of fistula.


RESULTS: No statistically significant difference was found between the groups by means of age, gender, the duration of dialysis, the body mass index (BMI), smoking, presence of diabetes and hypertension and serum total cholesterol levels. The level of serum albumin and hemoglobin of the dialysis patients with low BFR was highly statistically significantly low compared to the second group of dialysis patients with BFR of over 350 mL/min. The multiplication of serum calcium and phosphorus and the level of parathormon of the low BFR group were found to be statistically significantly high compared to the second group. When we evaluated the effects of parameters such as hemoglobin, serum albumin, multiplication of serum calcium-phosphorus and parathormon levels on low blood flow rate during hemodialysis; it was observed that the model was found highly significant and the level of serum albumin and the multiplication of serum calcium and phosphorus had a negative effect on low blood flow rate.


CONCLUSION: In dialysis performed with a rate of lower than 350 mL/min; serum albumin, hemoglobin, parathormon levels and the multiplication of serum calcium and phosphorus, which had approved prognostic value, were adversely affected.