Year: 2026 | Month: August | Volume: 13 | Issue: 8 | Pages: 502-508
DOI: https://doi.org/10.52403/ijrr.20260852
Outcomes of Arteriovenous Fistula Creation for Haemodialysis Access: A Prospective Cohort Study
Vishal Muttappa Gulappagol1, Prathvi Shetty2, N Srinath3, Vinay4
1Postgraduate Student, 2Professor, 3Professor & Head of Department, 4Professor
Department of Urology, Rajarajeswari Medical College and Hospital, Bengaluru, Karnataka, India
Corresponding Author: Vishal Muttappa Gulappagol
ABSTRACT
Arteriovenous fistula (AVF) is the preferred long-term vascular access for chronic haemodialysis because of its durability and low complication rate, yet primary failure remains common. This prospective cohort study evaluated outcomes of AVF creation and factors affecting maturation at the Department of Urology, Rajarajeswari Medical College and Hospital (RRMCH), Bengaluru, between July 2024 and January 2026. Seventy-five patients with end-stage renal disease (ESRD) underwent AVF creation after preoperative duplex ultrasonographic vascular mapping, with venous diameter reassessed at 8 weeks. Sixty fistulas (80%) were brachiocephalic and fifteen (20%) radiocephalic. Two patients died during follow-up; of the remaining 73, 57 (78.1%) achieved successful maturation and 16 (21.9%) had primary failure. Radiocephalic fistulas failed more often than brachiocephalic fistulas (71% vs 11%, p=0.045). Preoperative vein distensibility below 50% (OR 0.1, p=0.010) and vein diameter below 2mm (OR 6.9, p=0.005) independently predicted failure; a receiver operating characteristic curve identified a preoperative vein diameter cut-off of 2.25mm (AUC 0.741) for predicting successful maturation. Preoperative duplex ultrasonographic vascular mapping is a valuable, low-cost tool for optimising AVF outcomes, particularly for radiocephalic fistulas.
Keywords: Arteriovenous fistula; Haemodialysis; Vascular access; Primary failure; Duplex ultrasonography
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