Obese and non-obese hemodialysis patients have a similar prevalence of functioning arteriovenous fistula using pre-operative vein mapping

J. A. Vassalotti, A. Falk, E. D. Cohl, J. Uribarri, V. Teodorescu

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50 Scopus citations

Abstract

Aims: The arteriovenous fistula (AVF) is the preferred hemodialysis access. Subset analyses of both the HEMO and DOPPS studies have shown that obese hemodialysis patients have a lower prevalence of functioning AVF. Doppler ultrasound may increase the prevalence of functioning AVF in obese subjects. Patients and methods: The effect of pre-operative vein mapping employed between 10/01/98 and 12/08/00 on the prevalence of functioning AVF in a single university hemodialysis program was studied. Preoperative ultrasound was performed to study venous and arterial systems on both arms. Results: There were 50 obese patients, defined as body mass index (BMI) ≥27 kg/M2, and 130 patients with a lower BMI. The groups were similar in mean age and diabetes prevalence. The obese group had statistically significantly more females 34/50 versus 61/130 with p = 0.01. There was no statistically significant difference between the vein mapping parameters studied in the two BMI groups, including mean mid-forearm cephalic vein diameter, distal radial artery peak systolic velocity and subclavian vein patency. No obese patient required venography. There was no significant difference between the number of functioning AVF in both groups (22/50 obese, 48/130 lower BMI, p = 0.24). Conclusions: Pre-operative vein mapping is associated with a similar prevalence of functioning AVF in obese and lower BMI patients. Pre-operative ultrasound screening is a useful tool to promote AVF placement in obese patients.

Original languageEnglish
Pages (from-to)211-214
Number of pages4
JournalClinical Nephrology
Volume58
Issue number3
DOIs
StatePublished - Sep 2002

Keywords

  • Body mass index
  • Hemodialysis access
  • Obesity
  • Ultrasound
  • Vein mapping

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