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Article Type

Original Study

Abstract

Objective The aim of  the present study was to examine the use of brachiobasilic arteriovenous fistula (BBAVF) as a primary angioaccess for regular hemodialysis in patients having metabolic syndrome in comparison with distal forearm radiocephalic arteriovenous fistula (RCAVF). Patients and methods Sixty patients recently diagnosed with end-stage renal disease fulfilling the inclusion criteria for this study were selected from a total of 638 patients referred from the nephrologists clinic to the vascular clinic at Gamal Abdel-Nasser Hospital and Shebin El-Koum Hospital. The patients were randomly divided into two groups, the RCAVF group, which included 30 patients, and the BBAVF group, which also included 30 patients. All patients suffered from metabolic syndrome. Metabolic syndrome was defined as the presence of three or more of the following: blood pressure greater than 130/90 mmHg; triglycerides greater than 150 mg/dl; high-density lipoprotein less than 50 mg/dl for women and less than 40 mg/dl for men; BMI greater than 30 kg/m 2 ; or fasting blood glucose greater than 110 mg/dl. Results The patency rate after 1 year in BBAVF group was 27 (90.0%), and nine (30.0%) in the RCAVF group. Primary access failure in the BBAVF group was 6.7%, and 3.3% in the RCAVF group. Moreover, secondary access failure in the BBAVF group was 10%, and 70% in the RCAVF group. The number of metabolic syndrome criteria and incidence of angioaccess failure showed significantly low patency of RCAVF in patients fulfilling the fourth and fifth criteria for the metabolic syndrome. Conclusion BBAVF was found to have higher patency in comparison with RCAVF in metabolic syndrome patients with end-stage renal disease. However, establishing BBAVF as the first choice in metabolic syndrome patients needs further studies in the future.

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