Sajeev Kumar K. S1, Ajish John2, Jacob George3
BACKGROUND
Vascular calcification is common among patients with chronic kidney disease and can affect the outcome of AV fistula creation. Digital x-ray is a simple, but sensitive method to reveal vascular calcification. We aim to establish the relationship between vascular calcification on x-ray and outcome after radiocephalic AV fistula creation surgery.
MATERIALS AND METHODS
Chronic kidney disease patients undergoing radiocephalic AV fistula creation surgery in a single centre during one year period were prospectively studied for postoperative bleeding, primary failure and maturation of fistula. The outcome of the surgery was correlated with the vascular calcification detected in the digital x-ray (hands, abdomen and pelvis) using Adragao score and Kauppila index.
RESULTS
55 patients were enrolled for the study and vascular calcification was noted in 32 patients (58.2%). The mean Adragao score was 1.6±2.1 and Kauppila index was 3.6±4.2. Postoperative bleeding developed in 21.8% of cases, primary AV fistula failure developed in 18.2% and AV fistula nonmaturation in 20%. The presence of vascular calcification in the digital x-ray of hands as measured by Adragao score had significant correlation with postoperative bleeding, primary failure and nonmaturation of radiocephalic AV fistula. For every increase in the x-ray score of the hands by one, the risk of postoperative bleeding increases by 1.18 times, primary failure increases by 0.869 times and chance of AV fistula maturation decreases by 1.50 times.
CONCLUSIONS
Vascular calcification if visible in the x-ray of hands was associated with increased risk of postoperative bleeding, primary failure and nonmaturation of radiocephalic AV fistula.
