Comparison of Temporary Dialysis Catheter and A-V Fistula Use at the Time of Starting Chronic Hemodialysis among End-Stage Renal Diseases Patients

IntroductionThe preferred type of access for chronic hemodialysis (HD) is an Arterio-Venous (A-V) Fistula. However most of the ESRD patients does not have a mature fistula at the time of starting HD due to late referral to the nephrologists so the managing physicians have to use temporary catheters with high rate of complications. Materials and MethodsIn a retrospective study we determined and compared the prevalence of temporary catheters or A-VFistula use at the time of starting chronic HD from November 1995 to June 2009. We have divided our patients in three different groups. Group A: HD patients between 1995-2005, Group B: HD patients between 2006-2007, and Group C: HD patients after 2007. ResultsA total of 473 ESRD patients (288 male, 185 female; mean age, 55.8± 16.4 years) were included in the study. Causes of ESRD were HTN 34.1%, DM 20. 08%, glomeronephritis 9.72%, obstructive uropathy 8.46%, ADPKD 5.92%, and unknown 21.77%. Overall the prevalence of temporary catheters and A-V Fistula use were 86.5 and 13.5 percent. But the prevalence was different in the studied groups: group A (93.6% and 6.4%), in group B (85.0% and 15.0%) and in group C (67.5% and 29. 5%) respectively. There was a significant increase in A-V Fistula use after 2005 (p=0.00) and especially after 2007 (p=0.000).ConclusionAlthough there was a significant increment in the A-V Fistula use, it is not still enough and general physicians, nurses and chronic kidney disease patients have to be educated about the benefits of early A-V Fistula creation.