Casares-Bran T, Olivares-Cruz S, Lecuona-Huet N, Fabián-Mijangos W, Rodríguez-López E, Betanco-Peña A, León-Rey C

Language: Spanish
References: 0
Page: 163-169
PDF size: 172.31 Kb.

ABSTRACT

Introduction. Replacement therapy with hemodialysis is the most frequently used treatment for chronic renal failure worldwide. The vascular access of excellence is the arteriovenous fistula, because it is better functioning, has long-term duration and fewer complications compared to other types of access.
Material and methods. We did a review of 400 surgical procedures corresponding to arteriovenous fistulas for hemodialysis done in three years, with male predominance of 57.4%.
Results. The main cause of renal failure was: DM2 in 34.3%; 355 of the analyzedpatients, have their sessions of hemodialysis in another institution and only 9 in our institution. 100% of patients had at least one previous central venous catheter. Regarding the type of fistulas, 97.5% were autologous and the most frequent location was brachiocephalic at 52.25%. In the postoperative evaluation at 6 weeks, we found 298 fistulas matured and suitable to start hemodialysis, at 3 months of follow-up only 190 patients returned with matured fistulas and in use; 174 did not return for a new evaluation,so we do not know the functional status of the access. Complications occurred in 12.5%, the main one being the development of venous hypertension.
Conclusion. The early reference of the patient with chronic renal insufficiency to the vascular surgeon, to make an adequate planning of the first access and the consideration of others, as well as the early attention of the complications for timely treatment, allows a greater success of the vascular access and increased quality of life of patients.