Time to Primary Arteriovenous Fistula Failure and it’s Predictors among Patients Undergone Arteriovenous Fistula at Saint Paul’s Hospital Millennium Medical College, Ethiopia

Abstract

Background: Primary arteriovenous fistula failure, which we define as an arteriovenous fistula that is never usable or fails within the first three months of its creation, is a major problem. A significant number of arteriovenous fistulae (28 to 53%) never mature to support dialysis. As far as my search is concerned, this study is the first study in Ethiopia. Objective: This study aims to assess the time to primary arteriovenous fistula failure and its predictors among patients undergone arteriovenous fistula at Saint Paul’s hospital millennium medical college, Addis Ababa, Ethiopia 2024. Methods: A hospital-based retrospective follow up study was conducted among 328 patients undergone Arteriovenous fistula at Saint Paul’s Hospital Millennium Medical College renal center using Consecutive sampling technique of Renal patient records from December1st, 2020 to December 2023. Descriptive statistics was used to describe the characteristics of the renal patients. Bi-variable and multivariable cox-regression analysis was run to identify the predictors. Cox proportional hazard model fitness was checked by using global test and cox-Snell residuals plot. The variables with P-value of less than 0.25 was the candidate variables for multivariable cox-regression. Adjusted hazard ratio, with 95% CI and p-value was used to assess the strength of association and statistical significance. Kaplan-Meier survival curve together with the log rank test was checked to test the survival time of arteriovenous fistula. The variables with p-value of < 0.05 were considered significant and data was presented with narratives, tables and figures. Results: Three hundred and twenty-eight (328) study participants were involved. Of these, 235 (71.6%) of study participants was male and 28.8% of them experienced fistula failure. The incidence rate was roughly 30 per 100 person per month where median time is 2 months (IQR=1 to 4,95%CI (1.5-2.5)). Being Female (AHR:1.70, 95% CI (1.04-2.80)) and thrombosis (AHR:1.90,95%CI (1.19-3.04)) is significant predictors of arteriovenous fistula failure. Conclusion: The incidence of primary arteriovenous fistula was high in the first two months and in which median survival time of primary arteriovenous fistula was two months. Being female and having history of thrombosis were found predictors of arteriovenous fistula failure.