Vascular access in Senegalese patients starting chronic haemodialysis

African Journal of Nephrology

article

Moustapha Faye¹  Ismail Raqui¹  Maria Faye²  Bacary Ba¹  Ahmed Tall Lemrabott²  Sidy MohamedSeck³  Abdou Niang²  Elhadji FaryKa² 

[1] Aristide Le Dantec University Hospital of Dakar;Cheikh Anta Diop University of Dakar;Gaston Berger University of Saint-Louis, Ouakam Military Hospital;Dalal Jamm Hospital of Guédiawaye

关键词: arteriovenous fistula;    arteriovenous graft;    haemodialysis catheter;    Senegal;   

DOI  :  10.21804/26-1-5381

学科分类：数学（综合）

来源: African Association of Nephrology

【 摘 要 】

Introduction: It is recommended that patients should start chronic haemodialysis using an arteriovenous fistula (AVF) . We aimed to determine the proportion of Senegalese patients who used an AVF at the start of  haemodialysis and examined the factors associated with its use.Methods: We conducted a cross-sectional study from 1 June 2021 to 2 October 2021 among patients on chronic haemodialysis in 10 centres in the Dakar and Thiès regions. Clinical and laboratory data were collected from medical records and also via patient interviews.Results: The patients (n = 543) had a median age of 50 years [interquartile range (IQR) 40–62 years] and 50.6% were male. The socio-economic level was low in two-thirds of cases. The median duration of haemodialysis was 40 (IQR 17–76) months. Hypertension was noted in 92% and diabetes in 13%. Hypertensive kidney disease was the cause of kidney failure in 33%. Only 47 patients (9%) had started dialysis using an arteriovenous fistula. Factors associated with its use at haemodialysis initiation were socio-economic level (OR 0.48; 95% confidence interval (CI) 0.25–0.94 for low socio-economic level) and duration of pre-dialysis follow-up by a nephrologist for >4 months (OR 7.82; 95% CI 3.05–26.50). In 65% of prevalent patients, the vascular access used was an AVF, a tunnelled central venous catheter in 28%, an arteriovenous graft in 2% and a temporary central venous catheter in 4.4%.Conclusions: The proportion of Senegalese patients with an AVF at the start of haemodialysis was low. AVF use was associated with socio-economic level and pre-dialysis follow-up by a nephrologist for >4 months.

【 授权许可】

CC BY