Initial Five years of Arterio-Venous Fistula creation for Haemodialysis vascular access in Maiduguri, Nigeria

Background: Arterio-Venous Fistula (AVF) is the preferred method of vascular access for long-term maintenance haemodialysis in patients with kidney failure. The aim of this study was to assess our experience and outcome of native AVF that were constructed in our center in the initial 5 years of commencing the operation in the Kidney Center, University of Maiduguri Teaching Hospital, Nigeria. Method: We maintained a record of all the arteriovenous fistulae operations for the period January 2002 to December 2006. From the medical and operation records of the consecutive patients who had AVF placements in the initial 5 years, we analyzed the demographic characteristics, fistula types, complications and duration of use. Results: Thirty-six AVF operations were carried out on 32 patients who were made up of 22 males and 10 females. The ages of the patients ranged between 16 and 74 years with a mean 39.8 years for the study group. All the patients had their operations on the left upper limb with a total of 32 operations situated at the wrist (radiocephalic) while 4 were at the elbow (brachiocephalic). Three patients had primary fistula failure while 2 had reactionary haemorrhage that required reversal of the fistula. Conclusions: From our experience, the construction of native AVF for haemodialysis is both safe and cost effective. Arteriovenous fistulas last for long periods with a few manageable complications and as such we strongly recommend their placements for maintenance haemodialysis instead of the more frequently used catheters in many developing countries.