Kidney Week

Abstract: PUB131

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

Session Information

• Publication Only

Category: Dialysis

• 803 Dialysis: Vascular Access

Authors

• Ghonimi, Tarek Abdellatif, Hamad Medical Corporation, Doha, Doha, Qatar

Tarek Abdellatif Ghonimi, MD, PhD, FASN

• Elgaali, Musab, Hamad Medical Corporation, Doha, Doha, Qatar

Musab Elgaali, MD

• Fouda, Tarek Ahmed Elsayed, Hamad Medical Corporation, Doha, Doha, Qatar

Tarek Ahmed Elsayed Fouda, MD

• Ali, Mohamed Yousif Mohamed Salih, Hamad Medical Corporation, Doha, Doha, Qatar

Mohamed Yousif Mohamed Salih Ali, MBBS

• Ibrahim, Athar Ibrahim Hassan, Hamad Medical Corporation, Doha, Doha, Qatar

Athar Ibrahim Hassan Ibrahim, RN

• Alomari, Anees Jamil, Hamad Medical Corporation, Doha, Doha, Qatar

Anees Jamil Alomari, RN

• Hamad, Abdullah Ibrahim, Hamad Medical Corporation, Doha, Doha, Qatar

Abdullah Ibrahim Hamad, MD, FASN

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.

Digital Object Identifier (DOI)

• doi: 10.1681/ASN.2025fen4vhgw