OBJECTIVE AND STUDY DESIGN: This is a descriptive study, which aims to determine the incidence of vascular access complications among hemodialysis patients and to determine the demographic features of these patients.
POPULATION: Adult Filipino patients with end stage renal disease diagnosed to have vascular complications of their hemodialysis access from January 2000 to December 2002.
METHODOLOGY: The records of patients who were diagnosed to have vascular complications of their hemodialysis access from year 2000 to 2002 were reviewed. The patients' demographic characteristics, including risk factors for vascular disease, type of vascular complications, presenting signs and symptoms, and time of onset of complications from access creation were all noted.
RESULTS: Of the 2467 permanent access created between 2000-2002, there were 90 recorded vascular access complications (3.6 percent). Only 61 patients' records were available for review. Vascular access complications noted among these patients include: pseudoaneurysm 26 percent, thrombosis 21 percent, steal phenomenon 20 percent, stenosis 11.5 percent, thrombosis + pseudoaneurysm 11.5 percent, ruptured AVF 5 percent and distal venous hypertension 1.6 percent. Majority of patients presented with resistance to flow (26 percent), edema (25 percent) and palpable mass (20 percent). Only 13 percent of patients presented with pain and tenderness over the access site. 41 percent of vascular complications occurred more than 1 year from access creation with only 21.5 percent occurring in less than 3 months. The patency rates of AV fistulas and AV grafts were 91.5 percent and 79 percent at 3 months, and 79 percent and 64 percent at 1 year respectively.
The predominant risk factor noted, among these patients was hypertension (61 percent). 25 percent had associated diabetes mellitus and 23 percent had coronary artery disease. Only 25 percent of these patients were cigarette smokers. (Author)
The primary objective of this study is to determine the incidence of vascular complications of hemodialysis access among patients with end-stage renal disease from January 2000 to December 2002.
The specific objectives are to identify the vascular complications of hemodialysis access and its frequency; to describe the demographic features of patients who have access complications and to determine the proportion of patients with vascular complications who needed hospitalization and surgical procedures.