High-flow arteriovenous fistula and hemodynamic consequences at 1 year after kidney transplantation

Semin Dial. 2022 Mar;35(2):171-180. doi: 10.1111/sdi.13028. Epub 2021 Nov 2.

Abstract

Introduction: There are only scarce data regarding the cardiovascular impact of arteriovenous fistula after kidney transplantation depending on fistula flow.

Methods: We performed a single-center, prospective, cohort study including 49 patients with a functional fistula at 1 year from kidney transplantation. Patients were convened for a clinical work-up, a biological analysis, a fistula's Doppler ultrasonography and an echocardiography. Main judgment criterion was comparison of echocardiography parameters between patients with relative (fistula flow >1 L/min and a fistula flow/cardiac output ratio >20%), absolute high-flow fistula (fistula flow >2 L/min) and normal-flow fistula.

Results: High-flow fistula frequency was 69%. Significantly higher left ventricular end-diastolic and systolic diameters were observed in this group compared with the normal-flow fistula group (53 ± 6 vs. 48 ± 7 mm; p = 0.04 and 33 ± 6 vs. 28 ± 8 mm; p = 0.02) and between the absolute and relative high-flow fistula subgroups (56 ± 6 vs. 51 ± 6 mm; p = 0.009 and 35 ± 6 vs. 31 ± 5 mm; p = 0.01). The study showed no other significant differences.

Conclusions: This study showed a significantly higher but not pathological left ventricular end-diastolic and systolic diameters values in patients with high-flow fistula compared with patients with normal-flow fistula and between patients with respectively absolute and relative high-flow fistula.

MeSH terms

  • Arteriovenous Fistula* / diagnostic imaging
  • Arteriovenous Fistula* / etiology
  • Arteriovenous Shunt, Surgical* / adverse effects
  • Cohort Studies
  • Hemodynamics
  • Humans
  • Kidney Transplantation* / adverse effects
  • Prospective Studies
  • Renal Dialysis / adverse effects