Study of the Relationship between Vascular Access Types and Recirculation in Chronic Hemodialysis

Recirculation has an important role in hemodialysis. Since the base of hemodialysis therapy is its quality, survey recirculation rate is very important. This study aimed at determining access recirculation and its relationship with some factors in hemodialysis patients.

In this cross sectional study 83 chronic hemodialysis patients with catheter and arterio-venous fistula vascular access were selected in Imam Khomeini Hospital, Tehran, Iran in winter 2014. Urea based method was used to determine recirculation (with cut off 10%). For each patient KT/V, distance between arterial and venous needles and their directions, fistula location and hemodialysis time were recorded.

Fifty four and twenty nine patients were male and female, respectively and their average age was 58.2 years. Cause of kidney disease for 35% of patients was diabetic mellitus. Among patients 58 and 25 patients were dialysed through fistula and permanent catheter, respectively. Recirculation average in all patients was 11.6%. Effects of distance between arterial and venous needles, their directions and positions of catheters on average degree of recirculation was significant (P<0.05). Average degree of recirculation for patients with good adequate hemodialysis (KT/V > 1.2) was 8.35% (P<0.05).

With regards to significant effects of distance between arterial and venous needles, their directions and positions of catheters on average degree of recirculation it is clear that we can improve recirculation degree by emphasis on education and training of hemodialysis staffs.