Comparison of the mid-term results of proximal and distal radiocephalic arteriovenous fistulas created for hemodialysis

Patients and methods: Between January 2015 and December 2016, data of 120 patients (64 males, 76 females; mean age 63.5 years; range, 35 to 70 years) who underwent 75 distal and 65 proximal arteriovenous fistula operations in our clinic were retrospectively analyzed. The patients were divided into two groups as Group 1 (distal radiocephalic arteriovenous fistula; n=75) and Group 2 (proximal radiocephalic arteriovenous fistula; n=65). Demographic data of the patients, fistulas primary failure rates, and primary patency rates at six and 12 months were reviewed.

Results: There were no significant difference in primary failure rates and primary patency rates at six and 12 months between the groups (p>0.05). However, the rate of diabetes mellitus was statistically significantly higher in the proximal radiocephalic fistula group (p=0.041).

Conclusion: As the primary failure and primary patency rates at six and 12 months from distal and proximal were similar, we believe that patients with inappropriate vascular structure or in whom distal fistula intervention fails should be carefully evaluated for the chance of proximal radiocephalic fistula intervention before brachial fistula operation.