Predictive factors for arteriovenous fistula unsuccessful use in a population of end stage renal disease patients in Southeastern Mexico.

An arteriovenous fistula (AVF) is the preferred vascular access for long-term hemodialysis. The main disadvantage of AVF is the rate of non-maturation or unsuccessful use for hemodialysis (FUHD). We described our findings in AVF creation and possible risk factors associated with FUHD.Retrospective study of AVF´s during a 6-year period. Variables collected at time of creation were: demographics, comorbidities, replacement therapy, preoperative laboratory tests and estimated 6-month mortality on hemodialysis. All AVF´s were created in the upper arms. Outcomes were: FUHD, cannulation failure and cumulative survival. Univariate and multivariate analysis was performed to find possible risk factors for FUHD.AVF's were created in 78 patients. Average age was 36.3 years and 74.4% were male. Mean BMI was 24.5 kg/m2. The most etiology was glomerulopathy (53.6%) and diabetes mellitus (13.4%). Estimated six-month mortality was 4.2%. One patient underwent AVF prior to hemodialysis (mean dialysis time 2.2 years). Nineteen AVF's were considered FUHD (23.2%). Cannulation failure was 15.9%. AVF 1-year and 3-year survival was 67.8% and 63.5%. FUHD had higher estimated six-month mortality on hemodialysis, shorter prothrombin time and lower serum albumin than successful AVF (univariate analysis) (p< 0.05) Short prothrombin time and albumin were confirmed for FUHD (multivariate analysis). A 3.3 gr/dl serum albumin cutoff point (AUC 0.715, ROC) (p<0.05) was determined for FUHD.Population referred for AVF creation possesses different characteristics in our center. Good AVF outcomes can be achieved. Preoperative serum albumin and prothrombin time could be possible risk factors associated to unsuccessful AVF use.