Outcome of vascular access surgery for hemodialysis in end-stage renal disease

Background: Chronic kidney disease is a significant global health burden due to its high incidence and the risk of progression to end-stage renal disease (ESRD), cardiovascular disease, and premature death. Hemodialysis is a common kidney replacement therapy used for patients with ESRD with vascular access surgery crucial. Objectives: This study aims to evaluate the early and mid-term results of vascular access surgery. Subjects and Methods: A retrospective, descriptive case series study. At the TVS Department, Gia Dinh People's Hospital, from January 2020 to December 2022 were included. Results: The study involved 160 patients. Among the 125 patients had been follow up postoperation. The average age was 57 ± 14.5 years. Hypertension in 96.7%, diabetes in 44.7%, heart failure in 18.7%, and 10.6% had other comorbidities. Early results showed access occlusion in 18/141 cases (12.8%). Complications included 3.5% seroma and 2.1% distal limb ischemia syndrome. 77.3% with mature fistulas. Mid-term results showed 3.7% fistula occlusion during hemodialysis, and only 1 case experienced distal limb ischemia syndrome requiring ligation. 6.4% need to support from balloon dilation or branch ligation. Conclusion: Atrioveneous fistula for hemodialysis in ESRD patients has shown good results based on individual clinical examination and preoperative vascular ultrasound.