Comparison of Renal Function before and After Construction of Arterio-Venous Fistula in CKD Patients before Starting Hemodialysis

Abstract

Background: Arterio-Venous Fistula (AVF) formation  is  associated  with  significant  changes  in  haemodynamics,  left ventricular  ejection  fraction,   systemic haemodynamics, left ventricular function, glomerular filtration rate, renal blood flow, renal venous pressure, sodium and water retention and overall renal functions.  These changes are persistent even after AVF maturation. Objective: Evaluation of renal function in Chronic Kidney Disease patient after construction of Arterio-Venous fistula before starting Hemodialysis. Methods: This prospective observational study was carried out in 24 CKD patients underwent Arterio-Venous Fistula attended in the in department of Nephrology BSMMU, NIKDU, BIRDEM, Dhaka. during July 2015 and June 2016. Male and female patients aged more than 18 years and patient with CKD 5 who were clinically stable, including; AVF pending, any cause of renal failure, any co-morbid factors were enrolled in this study. Statistical analysis of the results was obtained by using windows computer software with Statistical Packages for Social Sciences (SPSS-version 22). Result: The mean age was found 48.5±10.44 years and male to female ratio was 2.43:1. Almost two third (62.5%) patients had radio cephalic fistula. The mean difference of Serum Creatinine level, blood urea and eGFR between before 4 months of AV fistula construction with at the time of AV fistula construction were statistically significant (p<0.05) however, at the time of AV fistula construction with after 4 months of AV fistula construction were almost alike with before 4 months of AV fistula construction, no significant (p>0.05) difference was found. Conclusion: This study demonstrated that rate of progression of CKD is decreased after construction of AV fistula.