Continuing arteriovenous fistula creation by nephrologist and its outcome during COVID pandemic—Analysis of 376 cases

Abstract

There has been a significant reduction of elective surgeries including creation of arteriovenous fistulas (AVF) during the ongoing pandemic by the surgeons. Here, we report the retrospective observational data of AVF creation by nephrologists in a single center, during a period of 8 months. A total of 376 fistulae were created in 310 patients. Patients were followed up at 2, 6, and 12 weeks. Twenty-eight patients required fistula creation twice, 16 patients thrice, and two patients underwent fistula creation four times. Of the total, 259 (68.8%) fistulae were radio-cephalic while 99 (26.3%) and 18 (4.79%) were brachio-cephalic and brachio-basilic, respectively. A total of 207 (67%) patients were already on hemodialysis whereas 103 (33%) were planned for elective initiation after fistula maturation. Of the 211 (69%) patients who completed 3 months of follow-up, 31 (15%) expired and 7 (3.3%) were lost to follow-up. Primary failure was observed in 70 (33.2%) fistulae. Fifteen (7.1%) patients were noted to be COVID positive during the follow-up. A total of 279 (90%) patients were alive at last follow-up. Amongst 20 dialysis staffs with 10 nephrologists, only two have developed COVID. Both were having mild illness and recovered completely. This study demonstrates that AVF creation can be performed safely with careful screening and by using adequate personal protective equipment.