Abstract

Audit of Haemodialysis Vascular Access in a Sub-Saharan Tertiary Hospital

Author(s): Dada Samuel Ayokunle*, Aremu Ayanwale Olusegun, Thomas Anthony Awolowo, Isijola Bukola Ibiso

Background: Guidelines recommend using Arteriovenous Fistulas (AVFs) as the preferred vascular access route for haemodialysis patients. However, in resource-poor settings, establishment and maintenance of AVFs can be challenging. This research aims to audit the current practices and outcomes of vascular access routes for haemodialysis at a tertiary hospital in sub-Saharan Africa.

Method and materials: This retrospective, descriptive analysis examines vascular access routes for haemodialysis at our dialysis centre over 11 years, utilising data collected from the medical records of patients who received haemodialysis.

Results: Among the 318 patients, males were more prevalent (61.3% vs. 38.7%). The average age was 49.7 years. Femoral catheters were most commonly used compared to other catheters. Catheter use lasted less than a month for two-thirds of patients (66.4%), while 24.8% used them beyond 6 months. Catheter-related infection (49.8%) was the most frequent complication followed by discomfort (25.8%). Discontinuation reasons included clinical improvement (especially in acute kidney injury patients, 52.0%), death (17.3%), transplantation (3.1%), bleeding (2.8%), and recurrent infection (6.0%). Conclusion: The implications of these findings are far-reaching, as suboptimal vascular access can negatively impact patient outcomes, quality of life, and the overall effectiveness of haemodialysis.