Primary Failure of Autogenous Arteriovenous Fistula: Critical Analysis

Introduction: Permanent vascular access is an essential intervention in patients with advanced chronic kidney disease (CKD) and its success depends on various non-modifiable and modifiable factors. Considering the element of unpredictability and failure, we attempted to analyze various factors responsible for primary arteriovenous fistula (AVF) failure in presumed high-risk groups. Materials and Methods: We conducted an observational study of newly created AVFs at a tertiary referral government hospital in Eastern India between January 2014 and June 2015. All adult CKD patients undergoing AVF creation were included. Primary AVF failure was assessed at 12 weeks and total follow-up was 24 weeks in presumed high-risk groups of females, patients aged ≥65 years and those with diabetes mellitus. Results: Female gender was at a higher risk of primary AVF failure if aged ≥65 years (P = 0.0026), second AVF creation (P = 0.03), loupe magnification not used (P = 0.03), arterial plaque (P = 0.028), absent immediate thrill, and with radiocephalic AVF (P = 0.02). Absent immediate thrill (