DOI: 10.36347/sjams.2014.v02i01.0071

Pages: 336-339

Fistula failure is frequent cause of increased mortality ,morbidity ,psychological and financial burden in End Stage Renal Disease(ESRD) patients who are on hemodialysis (HD) for survival in developing countries where renal transplants is not affordable by common people. There are multiple factors leading tofailure of arteriovenous fistula (AVF) in these patients like diabetes,atherosclerosis and out of these technical errors, hypotension, site of insertion, infection of fistula are the common preventable causes of failure. 244patients underwent dialysis from May 2005 to April 2013 for end stage renal disease and 55 patients (22.5%) never got AVF done for various reasons and therefore 189 patients (77.5%) with 224 AVF studied. In addition to underlying disease such as diabetes mellitus other factors such as hypotension ,infection gender,site, side differences recorded when AVF failed. Total of 189 (77.5%) patients, males constituted (79%), Non -DM (64.6%) A total of AVF 224 performed on 189 patients. and 77% of AVF were done on left hand and radial was predominant (55%).AVF failure was more in males (68.5%) compared to females(31.5%)and Non- DM (66%) had failures than diabetes(34%)because of the larger representation .AVF done on left (86%) failed as more number of fistula were on the that side. Similarly (80%) of radials failed.25 percent failed primarily (before dialysis) commonly due to drop in blood pressure and infections and improper selection of vessel for AVF and among the remaining 75%, 50% patients had functional AVF for at least 24 months and 25% of them 13 months functioned and then failed mainly due to hypotension during hemodialysis and recurrent failures were vessel thrombosis, technical difficulty.