Clinical factors associated with arteriovenous fistula patency among Japanese patients undergoing hemodialysis: a single-center retrospective study.

INTRODUCTION

Adequate vascular access is essential for stable hemodialysis treatment. Several clinical factors have been reported to affect arteriovenous fistula (AVF) patency;however, data focusing on Japanese patients remain limited. This study aimed to evaluate one-year AVF patency rates and associated clinical factors in Japanese patients.

METHODS

We retrospectively analyzed 580 patients who underwent AVF creation at a single center between July 2013 and December 2020. One-year AVF patency rates were estimated using the Kaplan-Meier method, and factors associated with AVF failure were examined using Cox proportional hazards regression.

RESULTS

The overall one-year primary, assisted primary, and secondary AVF patency rates were 15.4%, 78.3%, and 79.1%, respectively. In multivariate analyses, older age (adjusted HR 1.02, 95% CI 1.00-1.04), reduced preoperative cardiac function (ejection fraction ≤50%;adjusted HR 1.98, 95% CI 1.20-3.26), and catheter use at dialysis initiation (adjusted HR 1.51, 95% CI 1.02-2.22) were associated with an increased risk of AVF failure.

CONCLUSIONS

In Japanese patients undergoing hemodialysis, older age, reduced cardiac function, and catheter use at dialysis initiation were factors associated with one-year AVF failure. These findings highlight the importance of minimizing catheter use and assessing cardiovascular status when planning vascular access.