Mid-term outcome of arteriovenous fistula in paediatric patients with end-stage renal disease: A single centre experience

INTRODUCTION: The aim of the study was to evaluate the patency rates of arteriovenous fistula (AVF) in pediatric patients with end-stage renal disease (ESRD) in the mid-term.
METHODS: The study was conducted retrospectively. The medical archive was searched between January 2015 and February 2018. A total of 26 patients comprised the study population.
RESULTS: The median age and weight of the patients at the time of AVF creation were 13.2 years (IQR=11.9 – 15.6 years) and 41.5 kg (34.8 – 50.5 kg), respectively. Eight (69.2%) patents were male. The AVF created was radio-cephalic in 21 (80.8%) and brachial-level in 5 (19.2%) patients; brachio-cephalic in 3 and brachio-basilic in 2 patients. The patients with a radial-level AVF was younger (p=0.001), and the body weight of them was lower (p<0.001). In patients with radio-cephalic AVF, age (rs= -0.48, p=0.028) and weight (rs= -0.56, p=0.008) revealed negative correlation with duration of AVF maturation. The duration of follow-up was 21.2 month (IQR= 14.5 – 28.3 months). At 1 and 2 years, while the primary rates were 92.3% and 84.6%, the secondary patency rates were 96.2% and 92.3%, respectively.
DISCUSSION AND CONCLUSION: Our result showed that AVF is the most suitable and durable renal replacement therapy in patients with ESRD. The weight and level of AVF have a considerable influence on the duration of AVF maturation. In summary, the AVF still remains the procedure of choice in the regions where the pediatric kidney transplantation programmes are not completely set-up with resultant long waiting period for transplantation.