HEMODIALYSIS ADEQUACY AND RECIRCULATION RATIO ACCORDING THE PERMANENT VASCULAR ACCESS TYPE IN PATIENTS WITH CHRONIC HEMODIALYSIS

BACKGROUND: Dialysis adequacy is an important parameter with regards to morbidity and mortality in chronic hemodialysis patients. Besides many other factors affecting this parameter, the effect of different permanent vascular access types (PVA), essential for the hemodialysis treatment, on this parameter should be further investigated. As PVA 's, native arteriovenous fistulas (NAVF), graft (polytetrafluoroethylene) arteriovenous fistulas (GA VF) and permanent hemodialysis catheters (PHC) are used. One of the factors during the performing a PVA is to find an answer to whether or not the type of PVA has an effect on Kt/V ratio and recirculation (R%). Our purpose was to find whether there was any difference depending on the type of PVA in terms of Kt/V and R%


METHOD: Sixty-one patients who have been on hemodialysis with the same vascular access for the past 6 months were grouped according to their types of PVA. Of them, 37 were NAVF, 12 were GAVF and the remaining 12 were with PHC and they all received bicarbonate dialysis with low-flux dialysers 4 hours 3 times a week. Mean average Kt/V and R% ratios for six months were calculated. KruskalWallis H test was used for statistically analysis.


RESULTS: Mean average of Kt/V for six months was found as 1.29 +0.28 in 37 patients with NAVF, as 1.31 ±0.27 in 12 patients with GAVF and as 1.34 ±0.22 in 12 patients with PHC. R% was found 9.1 ±4.6% in NAVF, 8.1 ±4.1 % in GA VF and 6 ± 3.1 % in PHC. There was no significant difference among the three groups in terms of Kt/V and R% (p=0.68, p=0.3).


DISCUSSION: Dialysis adequacy and R% were found similar in three types of PVA. The type of PVA was not observed as an important factor in means of R% and dialysis adequacy. When creating a PVA, other characteristics of the patient and the cost of the procedure should be taken into consideration