VASCULAR ACCESS FOR HEMODIALYSIS - EXPERIENCE AT JOHANNESBURG-HOSPITAL

Abstract

Experience with angio-access in patients with chronic end-stage renal failure undergoing hemodialysis, including those with arteriovenous fistulas constructed within the past 3 yr, is reviewed. In patients in group 1,137 fistulas were constructed, the patency rate at 2 yr was 66% and at 4 yr 47%. Complications were due to thrombosis, aneurysm and poor operative technique. In group 2, fistulas were constructed from synthetic material in 33 patients; the patency rate at 2 yr was 44% and 36% at 4 yr. Complications were due to thrombosis and sepsis. No correlation was found between raised fibrinogen levels and fistula or graft failures. Dialysis needles of different gauges were compared; the 16-gauge Terumo needle caused no hemolysis and was adequate for use in dialysis.