Abstract

Redo arteriovenous fistula in end stage kidney disease: Risk factors and outcomes in Taiz – Yemen

Author(s): Nada Al-Wsabi, Abudar Al-Ganadi, Ismail Al Shameri*, Naseem Al-wsabi

Background: Reliable vascular access is fundamental for patients undergoing chronic hemodialysis. Although Arteriovenous Fistulas (AVFs) remain the preferred access modality due to superior long-term patency and lower complication rates, access failure remains common, necessitating redo AVF procedures.

Objective: To evaluate outcomes of redo AVF creation and identify risk factors associated with failure in patients with End-Stage Renal Disease (ESRD). Methods: This prospective observational study included 86 ESRD patients who underwent 98 redo AVF procedures between August 2021 and August 2023 at the Cardiovascular and Kidney Transplantation Center, Taiz, Yemen. Patient demographics, comorbidities, fistula configuration, complications, maturation, and patency rates were analyzed. Patients were followed for six months postoperatively.

Results: Brachiocephalic AVFs constituted the majority of redo procedures (60.2%), followed by brachiobasilic (28.6%), radiocephalic (5.1%), and arteriovenous grafts (5.1%). The overall maturation rate was 92.9%. Thrombosis was the most frequent complication (16.3%). Primary patency rates at 1, 3, and 6 months were 98%, 91.8%, and 82.7%, respectively.

Conclusion: Redo AVF creation is a feasible and effective strategy for maintaining long-term hemodialysis access, even in resource-limited settings. Early detection and prompt management of complications—particularly thrombosis—are crucial to optimizing outcomes.