A Study on Predictors of Outcome Following Radio-Cephalic Arteriovenous Fistula Creation in Patients with Chronic Renal Failure

Background: Radio-cephalic arteriovenous fistula (RC-AVF), particularly in the non-dominant limb, is widely regarded as the first choice for vascular access in hemodialysis. However, its success rate tends to decline in elderly patients and those with multiple comorbid conditions. Therefore, thorough preoperative assessment and vigilant postoperative observation are essential to address issues related to fistula maturation. This study was conducted to identify the various factors that influence the success of arteriovenous fistula creation. Methods: This prospective study enrolled patients aged between 20 and 65 years diagnosed with chronic kidney disease, who had not undergone any prior RC-AVF procedures. The study period ranged from February 1, 2021, to January 31, 2022. Multiple variables—preoperative, intraoperative, and postoperative—were evaluated for their potential effect on fistula outcomes. All AVF surgeries were performed using an end-to-side anastomosis technique with 7-0 prolene suture applied via interrupted sutures. Results: Among 250 enrolled patients, the highest fistula success rate (84%) was recorded in the 20–30 years age group. This was followed by 78% success rates in the 31–40 and 41–50 years groups. Male patients had a better success rate (61%) compared to female patients (39%). Additionally, a positive association was observed between successful fistula creation and the diameters of both the radial artery and cephalic vein. Conclusion: Effective maturation of arteriovenous fistulas is significantly linked to ongoing postoperative evaluation. For optimal outcomes, clinical monitoring should begin intraoperatively and be sustained throughout the postoperative phase.