When is the Best Time for the First Hemodialysis after Arteriovenous Fistula?

Ryu, Dong Hee; Jang, Lee Chan

Abstract

Long term patency of arteriovenous fistula depends on the many factors, such as patient factors, technical factors and hospital factors. Among these factors there has not been well-known about hospital factor such as timing of hemodialysis after AV fistula(maturation period) and hospital for patients to be cared. Generally from 4 to 6 weeks have been recommended for maturation period. But maturation period should be different according to patient condition especially arm venous status. To make guideline for maturation period, we would like to analyse the clinical results of 52 arteriovenous fistula from July 1991 to September 1995 at Chungbuk National University. Fifty two patients was divided into 2 groups according to arm venous status(poor vs good venous status) and hospital for patient to be cared. The decision for first hemodialysis was made by personnel in the hemodialysis room and length of venous thrill was measured at the time of first hemodialysis. One and 3 year overall patency rate were 93.2% and 67.1%. A mean maturation period and length of venous thrill are 6.2+/- 0.6 weeks and 18.7+/-0.9 cm. Maturation period in good venous status group was significantly less than poor venous status group and length of venous thrill was significantly longer than poor venous status group. The patency rate according to maturation period(less than 6 weeks vs more than 6 weeks)was not significant. But The patency rate according to length of venos thrill(less than 20 cm vs more than 20 cm) was statistically significant. There was no difference in patency rate according to hospitals for patients to be cared. In conclusion the length of venous thrill is more important than maturation period in decision of time for hemodialysis. If length of venous thrill after arteriovenous fistula is above 20 cm, it would be suitable for hemodialysis