Evaluation of Arteriovenous Access Dysfunction and Interventional Outcomes in Patients with ESKD on Maintenance Hemodialysis: A Retrospective Cohort Study

Background: AV access dysfunction is common in ESRD patients on hemodialysis (HD). This study evaluated dysfunction characteristics, interventional outcomes, and predictors of success. Methods: A retrospective analysis of 109 ESRD patients with AV access dysfunction undergoing interventions (Jan 2022-Dec 2024) in Qatar’s main dialysis center. Demographics, comorbidities, dysfunction types, procedures, outcomes, and success predictors were analyzed. Results: The cohort (mean age 61.01 ± 15.42 years, mean BMI 28.83 ± 6.02; 65.1% male) had hypertension (93.6%) and diabetes (70.6%). Mean access age at dysfunction was 35.4 ± 50.5 months. Most procedures were performed in Interventional Radiology (94.5%). The most frequent dysfunction was occlusion and thrombosis (52.3%), followed by bruit & thrill complications (25.7%). Common procedures included fistulogram + angioplasty (29.4%) and thrombectomy + thrombolysis + angioplasty (16.5%). Immediate success was 83.5%; 12.8% required re-procedures (92.9% success). Logistic regression showed higher BMI (OR=1.138, p=0.015) predicted success, while older access age (OR=0.991, p=0.058) was associated with lower success. Age, sex, and comorbidities were not significant. Conclusion: Occlusion/thrombosis is the primary AV dysfunction in ESRD. BMI and access age impact interventional success. Timely intervention considering these factors may improve outcomes and reduce re-interventions. Funding: Government Support – Non-U.S.