Comparison of Six-Month Patency Rate in Ulnar-Basilic Fistula and Radio-Cephalic Fistula for Hemodialysis Access

Abstract

Background and Objectives: There are different types of vascular access. We compared the patency rate for six months in ulnar-basilic fistula and Radio-Cephalic fistula for vascular access in hemodialysis patients. Methods: The study was performed on 60 patients of 50.6±13.5 years of age with end-stage renal failure undergoing hemodialysis from 2012-2014 in Imam Ali hospital in Zahedan. Patients were divided into two groups. The first group was established anastomosis of wrist radial artery and the cephalic vein and in second group between ulnar artery and vein Basilic in the forearm. Both groups were followed up with respect to patency of the fistula for six-month. Findings: The mean duration of renal failure requiring transplantation among patients was 1.4±1.0 year. The frequency of patency after six months in ulnar-basilic fistulas was less than that in Radio-Cephalic group, however, the difference was not significant (76% vs. 70%, P > 0.05). All fistulas in two groups showed thrill, except one patient (3.3%) in ulnar-basilic group (primary failure). Hypertension was detected in one patient in Radio-Cephalic group, moreover, hematoma was observed in two patients in ulnar-basilic and in two patients in Radio-Cephalic groups and thrombosis was observed in two patients in ulnar-basilic and in a single patient in Radio-Cephalic groups. The aneurism was observed in three patients (10%) in ulnar-basilic and in four patients in Radio-Cephalic fistulas. The steal syndrome was observed in two patients in Radio-Cephalic group, infection in one patient (3.3%) in ulnar-basilic fistulas group and in four patients (13.3%) in Radio-Cephalic group. Conclusions: Fistula patency rates were comparable in both ulnar-basilic and Radio-Cephalic groups and there is no significant evidence of postoperative complication difference between two groups.