Relationship between arteriovenous fistula cannulation practices and dialysis adequacy: A prospective, multicenter study

Abstract

Background: Successful arteriovenous fistula cannulation ensures maximum patient benefit in the haemodialysis procedure. Objective: The aim of this study was to determine the effect of various cannulation methods used for arteriovenous fistulas on dialysis adequacy. Design: It is a descriptive, cross-sectional and multicenter study. Participants: A total of 164 dialysis patients from four dialysis centers were included. Measurements: Data were collected by determining patients' characteristics and the arteriovenous fistula cannulation method used, in addition to recording the Kt/V and urea reduction ratio values to evaluate dialysis adequacy. The mean Kt/V and urea reduction ratio values over 3 months after dialysis initiation were used. This trial is registered with ClinicalTrials.gov, NCT04270292. Results: Cannulation with the puncture method was used in 53% of the patients; the fistula needles were inserted in the antegrade direction in 43.9% of the patients; the arterial needle was rotated after fistula needle placement in 63.4% of the patients; and the arterial and venous needles were on the same vascular line in 15.2% of the patients. Placement of the fistula needle in the antegrade direction increased the Kt/V value 0.164 times (95% confidence interval: 0.002–0.212, p =.047). Conclusion: Antegrade placement could be a factor influencing dialysis adequacy. We suggest antegrade interventions to the fistula to maximize the patient benefit from the haemodialysis treatment. © 2021 European Dialysis and Transplant Nurses Association/European Renal Care Association