Frequency of Different Vascular Access Types Used in Hemodialysis Centers of Gorgan, Iran (2020-21)

Abstract

Background and Objective: Hemodialysis is an important replacement therapy for 70-90% of patients with end-stage renal disease (ESRD). Arteriovenous fistula (AVF) is the vascular access of choice in these patients due to its higher efficiency and lower risk of mortality compared to arteriovenous grafts. This study was conducted to determine the frequency of vascular access types used in hemodialysis centers of Gorgan, Iran. Methods: This descriptive-analytical study was done on 200 hemodialysis patients (101 men and 99 women) at 5 Azar and Sayyad Shirazi hospitals in Gorgan, north of Iran, during April 2020 to July 2021. The subjects were selected by the census method. Information including age, sex, education level, duration of dialysis, the initial and current types of vascular access, site of vascular access, history of diabetes or hypertension, race, and history of smoking were recorded in a checklist. Results: The mean age of women and men was 58.34±4.71 and 57.95±13.76 years, respectively. In addition, 61.5% of the patients were under 3 years old. The most commonly used vascular access to initiate dialysis was non-cuffed temporary catheters (69%) and AVF (24%). Smoking, ethnicity, diabetes, hypertension, and gender had no significant association with the type of vascular access used. In addition, there was no significant relationship between the duration of dialysis and the type of vascular access. Conclusion: Considering the diversity of catheters and fistulas, it is necessary to emphasize that the use of AVF in patients undergoing dialysis for the first time and the timely placement of AVF in ESRD patients can improve the quality of life of the patients. It is also recommended to use jugular catheters instead of subclavian catheters when required.

Keywords

• end stage renal disease
• hemodialysis
• vascular access devices
• arteriovenous fistula
• arteriovenous grafts
• iran