Outcomes of Native Arteriovenous Fistula Creation for Haemodialysis in South-West Nigeria: A 5-Year Review from the Cardiovascular and Thoracic Surgery Unit of a Tertiary Institution

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Background: Successful creation of a long-lasting haemodialysis access is one of the cornerstones in the management of patients with end stage kidney failure (ESKF). Arteriovenous fistula (AVF) of native vessels is preferred over prosthetic grafts and central venous catheters because, at comparable flow rates, it is associated with lower complications. Objectives: To evaluate the early experience and outcomes of native AVF creation at a tertiary cardiovascular centre in south-west Nigeria. Materials and Methods: We retrospectively reviewed all patients with complete documentation who had native atrioventricular fistula creation from January 2019 to December 2023. Data was obtained from hospital medical records using a predesigned proforma. The data included demographic characteristics, aetiology of ESKF, previous haemodialysis, preoperative assessment, type of AVF, maturity, complications, and outcome. Results: Sixty-four patients who had native AVF creation were reviewed. There were 40 males (62.5%) and 24 females (37.5%) in the study. Distal radiocephalic AVF was the most common type of AVF performed. Primary failure was observed in seven patients (10.9%), and 10 patients were lost to follow-up. Excluding patients who were lost to follow-up, 47 (87.0%) AVFs attained maturity, and pseudoaneurysm occurring in 4 (6.2%) patients was the most common complication in this cohort. Conclusions: In patients with ESKF with favourable vessel characteristics, native AVF remains a valuable long-term access for chronic haemodialysis with acceptable maturity rates, minimal complications, and a satisfactory outcome.

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