Vascular accesses in chronic hemodialysis: Clinical implications and comparative survival between autologous fistulas and tunneled catheters

Background: Vascular access is essential in replacement therapy through chronic hemodialysis, as it directly influences patient survival and the occurrence of complications. This retrospective study compared 12-month survival between autologous arteriovenous fistulas and tunneled venous catheters in patients with chronic kidney disease treated in a tertiary care hospital unit. The autologous fistula was the most commonly used access type and showed a significantly higher mean survival compared to catheters (p < 0.05). Late complications, such as dysfunction and bacteremia, were mainly associated with catheter use, while the presence of cardiometabolic comorbidities was linked to a shorter functional duration of the access. The findings support the recommendation to prioritize autologous arteriovenous fistulas when clinical and anatomical conditions allow, highlighting the importance of proper preoperative planning to improve outcomes in chronic hemodialysis patients. Keywords: hemodialysis, vascular access, arteriovenous fistula, tunneled catheter, survival, comorbidities.