Arteriovenous Fistula Versus Central Venous Catheter: A Systematic Review of Impact on Quality of Life in Hemodialysis Patients

Background Vascular access, primarily through arteriovenous fistula (AVF) or central venous catheter (CVC), significantly improves survival and health-related quality of life (HRQoL) in patients with end stage kidney disease. Although AVF is preferred, CVC may offer advantages in specific clinical contexts. This systematic review evaluates the comparative impact of AVF and CVC on HRQoL in patients on hemodialysis. Materials and Methods A literature search was conducted across PubMed, DOAJ, and EBSCO, using the keywords “vascular access,” “quality of life,” and “hemodialysis.” The included studies were observational, involved adult hemodialysis patients, were published in English with full text available, and utilized validated HRQoL tools. Study quality was assessed using the Newcastle-Ottawa Scale. (CRD420251068752). Results From the 15 included studies (9,889 participants: 5,871 AVF, 4,018 CVC), 12 found significant benefits of AVF on HRQoL domains, primarily in disease-specific areas, physical domains, and mental domains. Additionally, AVF showed advantages in vascular access-related aspects. Conversely, four studies indicated CVC superiority in select subdomains, such as pain, general health perception, role-emotional, vascular access satisfaction, bleeding, swelling, bruising, daily activities, and appearance. Two studies reported no significant differences between AVF and CVC. Conclusion AVF is generally associated with better HRQoL in hemodialysis patients than CVC.