Survival and Prognostic Predictors of Primary Arteriovenous Fistula for Hemodialysis

Abstract

Objectives: This study aims to evaluate the survival and prognostic predictors of arteriovenous fistulas (AVFs) among patients undergoing AVF creation. The significant predictors were incorporated into a prognostic model to determine its prognostic performance for five-year AVF survival. Materials and Methods: Data on 290 patients who underwent first-time AVF creation and who had been followed up for at least 5 years or until AVF failure were reviewed. The Kaplan-Meier survival curves and Cox proportional hazards model were generated to determine the AVF survival and associated prognostic predictors. Significant predictors were used to derive a prognostic model. Results: The mean age of the patients was 59.7±14.6 years, and the 5-year AVF survival rate was 34.5%. Three features were found to be independent prognostic factors for the five-year AVF survival: old age, diabetes mellitus, and prior central venous catheter placement. These three significant factors were integrated into a prognostic scoring model that ranged from zero to five points. According to this model, the patients whose scores were 0, 1, 2, 3 and 4 or more had five-year AVF survival rates of 60.0%, 45.3%, 36.6%, 15.0%, and 2.9%, respectively. Conclusion: The five-year survival rate of AVFs was modest, and a prognostic model could excellently estimate the five-year AVF survival.