Assessing the Impact of Hemodialysis Arteriovenous Access on Echocardiographic Findings in Chronic Kidney Disease Patients: A Cross-Sectional Study

A Background: Chronic kidney disease (CKD) is an increasingly serious health problem. Between 2009 and 2019, it was the fifth leading cause of death. If not managed properly, CKD can progress to renal failure and is associated with complications such as early cardiovascular disease. The relationship between vascular access and cardiac function is complex, and its effect on cardiac output (CO) is not yet fully understood. High-flow access is defined as a blood flow rate (Qa) between 1000 and 1500 ml/min or greater than 20% of cardiac Output. Aims: Our study aimed to assess the relationship between arteriovenous access and echocardiographic findings in patients with CKD. Subjects and Methods: This comparative cross-sectional Study compared 75 CKD patients divided into three groups: hemodialysis patients with arteriovenous access, non-hemodialysis patients with arteriovenous access, and non-hemodialysis patients not having arteriovenous access. Patients were interviewed and clinically examined, and blood samples were collected. Using a transthoracic echocardiographic study, the study assessed the venous flow volume of the fistula and structural and functional echocardiographic findings. Results: Doppler venous flow was significantly higher in hemodialysis patients with arteriovenous access compared to non-hemodialysis patients with arteriovenous access, with concentric LVH being higher in the non-dialysis group. Using multivariate logistic regression analysis, gender, smoking, and diastolic dysfunctions were significantly associated with higher Doppler venous flow. Conclusion: we found a significant association between high-flow fistula and echocardiographic Changes In left ventricle hypertrophy (LVH), pulmonary hypertension (PHT), diastolic dysfunction, and left-sided valvular regurgitation.