Obesity is not an obstacle for successful autogenous arteriovenous fistula creation in haemodialysis
Background. Obesity, which is often associated with diabetes, is increasingly encountered in the haemodialysed population, and this may produce difficulty in autogenous arteriovenous fistula creation. Prosthetic angioaccess or catheters, when used in place of autogenous fistulas, increase thrombotic...
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| Veröffentlicht in: | Nephrology, dialysis, transplantation dialysis, transplantation, 2008-04, Vol.23 (4), p.1318-1322 |
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| creator | Weyde, Waclaw Krajewska, Magdalena Letachowicz, Waldemar Porazko, Tomasz Watorek, Ewa Kusztal, Mariusz Banasik, Miroslaw Gołebiowski, Tomasz Bartosik, Hanna Madziarska, Katarzyna Janczak, Dariusz Klinger, Marian |
| description | Background. Obesity, which is often associated with diabetes, is increasingly encountered in the haemodialysed population, and this may produce difficulty in autogenous arteriovenous fistula creation. Prosthetic angioaccess or catheters, when used in place of autogenous fistulas, increase thrombotic and infectious complications in these already challenged patients. Methods. This prospective study was undertaken to assess the feasibility of autogenous arteriovenous fistula creation in 71 obese patients (BMI 34.6 ± 7.8). We performed a two-stage procedure, in which radio-cephalic fistula formation was followed by subcutaneous transposition of the venous component for safe and easy puncture. Results. Fistulas suitable for puncture, having blood flows of 799 ± 285 ml/min, and sufficient to perform adequate haemodialysis (Kt/V 1.24) were achieved in 85% of the patients. Primary patency rates were 65% and 59% at 6 and 12 months, respectively, and secondary patency rates were 83% both at 6 and 12 months. Conclusions. Obesity does not prevent successful autogenous arteriovenous fistula formation, and may protect forearm venous vessels from the iatrogenic damage that occurs before the onset of haemodialysis therapy. |
| doi_str_mv | 10.1093/ndt/gfm739 |
| format | Article |
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Obesity, which is often associated with diabetes, is increasingly encountered in the haemodialysed population, and this may produce difficulty in autogenous arteriovenous fistula creation. Prosthetic angioaccess or catheters, when used in place of autogenous fistulas, increase thrombotic and infectious complications in these already challenged patients. Methods. This prospective study was undertaken to assess the feasibility of autogenous arteriovenous fistula creation in 71 obese patients (BMI 34.6 ± 7.8). We performed a two-stage procedure, in which radio-cephalic fistula formation was followed by subcutaneous transposition of the venous component for safe and easy puncture. Results. Fistulas suitable for puncture, having blood flows of 799 ± 285 ml/min, and sufficient to perform adequate haemodialysis (Kt/V 1.24) were achieved in 85% of the patients. Primary patency rates were 65% and 59% at 6 and 12 months, respectively, and secondary patency rates were 83% both at 6 and 12 months. Conclusions. Obesity does not prevent successful autogenous arteriovenous fistula formation, and may protect forearm venous vessels from the iatrogenic damage that occurs before the onset of haemodialysis therapy.</description><identifier>ISSN: 0931-0509</identifier><identifier>EISSN: 1460-2385</identifier><identifier>DOI: 10.1093/ndt/gfm739</identifier><identifier>PMID: 17956889</identifier><identifier>CODEN: NDTREA</identifier><language>eng</language><publisher>Oxford: Oxford University Press</publisher><subject>Adolescent ; Adult ; Aged ; Aged, 80 and over ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Arteriovenous Shunt, Surgical - methods ; autogenous fistula ; Biological and medical sciences ; Emergency and intensive care: renal failure. Dialysis management ; Female ; Follow-Up Studies ; Humans ; Intensive care medicine ; Kidney Failure, Chronic - complications ; Kidney Failure, Chronic - therapy ; Male ; Medical sciences ; Middle Aged ; obesity ; Obesity - complications ; Prospective Studies ; radio-cephalic fistula ; Renal Dialysis - methods ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Surgery of the urinary system ; transposition ; Treatment Outcome ; vascular access</subject><ispartof>Nephrology, dialysis, transplantation, 2008-04, Vol.23 (4), p.1318-1322</ispartof><rights>Oxford University Press © The Author [2007]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org 2007</rights><rights>2008 INIST-CNRS</rights><rights>The Author [2007]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c446t-cb695851583b44c63bee062e1a1ec6a7b1236be7dd17e6c5df60f777090aea623</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,1583,27923,27924</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=20253893$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/17956889$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Weyde, Waclaw</creatorcontrib><creatorcontrib>Krajewska, Magdalena</creatorcontrib><creatorcontrib>Letachowicz, Waldemar</creatorcontrib><creatorcontrib>Porazko, Tomasz</creatorcontrib><creatorcontrib>Watorek, Ewa</creatorcontrib><creatorcontrib>Kusztal, Mariusz</creatorcontrib><creatorcontrib>Banasik, Miroslaw</creatorcontrib><creatorcontrib>Gołebiowski, Tomasz</creatorcontrib><creatorcontrib>Bartosik, Hanna</creatorcontrib><creatorcontrib>Madziarska, Katarzyna</creatorcontrib><creatorcontrib>Janczak, Dariusz</creatorcontrib><creatorcontrib>Klinger, Marian</creatorcontrib><title>Obesity is not an obstacle for successful autogenous arteriovenous fistula creation in haemodialysis</title><title>Nephrology, dialysis, transplantation</title><addtitle>Nephrol Dial Transplant</addtitle><addtitle>Nephrol Dial Transplant</addtitle><description>Background. Obesity, which is often associated with diabetes, is increasingly encountered in the haemodialysed population, and this may produce difficulty in autogenous arteriovenous fistula creation. Prosthetic angioaccess or catheters, when used in place of autogenous fistulas, increase thrombotic and infectious complications in these already challenged patients. Methods. This prospective study was undertaken to assess the feasibility of autogenous arteriovenous fistula creation in 71 obese patients (BMI 34.6 ± 7.8). We performed a two-stage procedure, in which radio-cephalic fistula formation was followed by subcutaneous transposition of the venous component for safe and easy puncture. Results. Fistulas suitable for puncture, having blood flows of 799 ± 285 ml/min, and sufficient to perform adequate haemodialysis (Kt/V 1.24) were achieved in 85% of the patients. Primary patency rates were 65% and 59% at 6 and 12 months, respectively, and secondary patency rates were 83% both at 6 and 12 months. Conclusions. Obesity does not prevent successful autogenous arteriovenous fistula formation, and may protect forearm venous vessels from the iatrogenic damage that occurs before the onset of haemodialysis therapy.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>Arteriovenous Shunt, Surgical - methods</subject><subject>autogenous fistula</subject><subject>Biological and medical sciences</subject><subject>Emergency and intensive care: renal failure. Dialysis management</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>Intensive care medicine</subject><subject>Kidney Failure, Chronic - complications</subject><subject>Kidney Failure, Chronic - therapy</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>obesity</subject><subject>Obesity - complications</subject><subject>Prospective Studies</subject><subject>radio-cephalic fistula</subject><subject>Renal Dialysis - methods</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. 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Intensive care medicine. Transfusions. Cell therapy and gene therapy</topic><topic>Arteriovenous Shunt, Surgical - methods</topic><topic>autogenous fistula</topic><topic>Biological and medical sciences</topic><topic>Emergency and intensive care: renal failure. Dialysis management</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Humans</topic><topic>Intensive care medicine</topic><topic>Kidney Failure, Chronic - complications</topic><topic>Kidney Failure, Chronic - therapy</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>obesity</topic><topic>Obesity - complications</topic><topic>Prospective Studies</topic><topic>radio-cephalic fistula</topic><topic>Renal Dialysis - methods</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><topic>Surgery of the urinary system</topic><topic>transposition</topic><topic>Treatment Outcome</topic><topic>vascular access</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Weyde, Waclaw</creatorcontrib><creatorcontrib>Krajewska, Magdalena</creatorcontrib><creatorcontrib>Letachowicz, Waldemar</creatorcontrib><creatorcontrib>Porazko, Tomasz</creatorcontrib><creatorcontrib>Watorek, Ewa</creatorcontrib><creatorcontrib>Kusztal, Mariusz</creatorcontrib><creatorcontrib>Banasik, Miroslaw</creatorcontrib><creatorcontrib>Gołebiowski, Tomasz</creatorcontrib><creatorcontrib>Bartosik, Hanna</creatorcontrib><creatorcontrib>Madziarska, Katarzyna</creatorcontrib><creatorcontrib>Janczak, Dariusz</creatorcontrib><creatorcontrib>Klinger, Marian</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Immunology Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Nephrology, dialysis, transplantation</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Weyde, Waclaw</au><au>Krajewska, Magdalena</au><au>Letachowicz, Waldemar</au><au>Porazko, Tomasz</au><au>Watorek, Ewa</au><au>Kusztal, Mariusz</au><au>Banasik, Miroslaw</au><au>Gołebiowski, Tomasz</au><au>Bartosik, Hanna</au><au>Madziarska, Katarzyna</au><au>Janczak, Dariusz</au><au>Klinger, Marian</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Obesity is not an obstacle for successful autogenous arteriovenous fistula creation in haemodialysis</atitle><jtitle>Nephrology, dialysis, transplantation</jtitle><stitle>Nephrol Dial Transplant</stitle><addtitle>Nephrol Dial Transplant</addtitle><date>2008-04-01</date><risdate>2008</risdate><volume>23</volume><issue>4</issue><spage>1318</spage><epage>1322</epage><pages>1318-1322</pages><issn>0931-0509</issn><eissn>1460-2385</eissn><coden>NDTREA</coden><abstract>Background. Obesity, which is often associated with diabetes, is increasingly encountered in the haemodialysed population, and this may produce difficulty in autogenous arteriovenous fistula creation. Prosthetic angioaccess or catheters, when used in place of autogenous fistulas, increase thrombotic and infectious complications in these already challenged patients. Methods. This prospective study was undertaken to assess the feasibility of autogenous arteriovenous fistula creation in 71 obese patients (BMI 34.6 ± 7.8). We performed a two-stage procedure, in which radio-cephalic fistula formation was followed by subcutaneous transposition of the venous component for safe and easy puncture. Results. Fistulas suitable for puncture, having blood flows of 799 ± 285 ml/min, and sufficient to perform adequate haemodialysis (Kt/V 1.24) were achieved in 85% of the patients. Primary patency rates were 65% and 59% at 6 and 12 months, respectively, and secondary patency rates were 83% both at 6 and 12 months. Conclusions. Obesity does not prevent successful autogenous arteriovenous fistula formation, and may protect forearm venous vessels from the iatrogenic damage that occurs before the onset of haemodialysis therapy.</abstract><cop>Oxford</cop><pub>Oxford University Press</pub><pmid>17956889</pmid><doi>10.1093/ndt/gfm739</doi><tpages>5</tpages><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; Oxford University Press Journals All Titles (1996-Current); EZB-FREE-00999 freely available EZB journals; Alma/SFX Local Collection |
| subjects | Adolescent Adult Aged Aged, 80 and over Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Arteriovenous Shunt, Surgical - methods autogenous fistula Biological and medical sciences Emergency and intensive care: renal failure. Dialysis management Female Follow-Up Studies Humans Intensive care medicine Kidney Failure, Chronic - complications Kidney Failure, Chronic - therapy Male Medical sciences Middle Aged obesity Obesity - complications Prospective Studies radio-cephalic fistula Renal Dialysis - methods Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Surgery of the urinary system transposition Treatment Outcome vascular access |
| title | Obesity is not an obstacle for successful autogenous arteriovenous fistula creation in haemodialysis |
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