European Journal of Molecular & Clinical Medicine

In India, chronic kidney disease (CKD) is presently the third most prevalent non-communicable disease. Kidney function is reduced progressively and irreversibly as a result of CKD. The most popular treatment for chronic renal disease is hemodialysis (HD). An arteriovenous fistula (AVF)is the most typical vascular access point for those who need to undergo hemodialysis. However, HD patients always have severe concerns about the pain that is associated with AVF cannulation. The researcher aims to assess the effectiveness of ice massage at the Hegu point on AVF puncture-related pain among hemodialysis. The main objective of the study is to evaluate the AVF puncture-related pain scores in HD patients with and without Hegu point ice massage and to correlate the AVF puncture-related pain scores with selected biographical variables.

Current DOQI guidelines encourage creating arteriovenous fistulas in more number of hemodialysis patients. However, many new fistulas fail to mature enough for use in hemodialysis. Preoperative vascular mapping to select suitable vessels may improve vascular access outcomes. Thus our study aims to evaluate role of preoperative vascular mapping in fistula maturation.
Results: Among 54 radiocephalic fistulas, mean preoperative radial artery diameter and cephalic vein diameter at wrist was 2.24 + 0.53 mm and 2.05 + 0.58 mm respectively in successful group. The mean radial artery PSV was 47.57 + 7.67 cm/sec in successful group with p value<0.001. Thrombosis was the most common complication seen in about 18.5%. Overall maturity rate of 77.8% was recorded at 4 weeks with primary failure rate of 22.2%.
Conclusion: Duplex ultrasound reliably evaluates both structural and functional aspects of the peripheral vessels and helps in preoperative vascular mapping .Hence, preoperative ultrasound should be used to improve AVF outcome

Introduction: Arteriovenous fistula (AVF), permanent catheter (PC), and vascular graft are three vascular access types used for hemodialysis (HD) procedure. Due to insufficient reliable information on the comparison between AVF and PC.  This study was conducted to compare AVF and PC regarding adequacy of dialysis.
Material and Methods: This prospective study was carried out in tertiary care center over 6 months (Jan 2021 to June 2021). In this study, 100 HD pts were enrolled and assigned to two unequal groups of AVF and PC. Before and after the dialysis session, blood samples were taken for laboratory examinations and measurement of urea reduction ratio and Kt/V. The patients were followed up for six months, and then laboratory examinations were repeated.
Results: Out Of the 100 HD pts, 40 had AVF and 60 patients on PC. During the 6-month follow-up, 30 patients in PC group but only two  patient in AVF group showed infection (P = 0.050), while in each group,  thrombosis were seen in 6 patients on PC and 4 patients of AVF (P = 0.50). Catheter dysfunction was seen in 15 patients of PC group and one patients of AVF group (P = 0.0001).There was no difference between the two groups in Kt/V and URR at the beginning of the study; however, after six months, Kt/V and URR were greater in AVF group (P< 0.05).
Conclusion: We found better dialysis adequacy in AVF group & there were some advantages of AVF over PC, such as lower rate of infection and thrombosis. We recommend that AVF be created in all of patients with chronic kidney disease who are candidates for HD.