Almási-Sperling Veronika, Gall Christine, Haney Briain, Latzel Nina, Knieling Ferdinand, Hilger Alina C, Regensburger Adrian P, Meyer Alexander, Lang Werner, Rother Ulrich
Department of Vascular Surgery, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Krankenhausstraße 12, 91054 Erlangen, Germany.
Department of Medical Informatics, Biometry and Epidemiology, University of Erlangen-Nuremberg, 91054 Erlangen, Germany.
J Clin Med. 2024 Jun 18;13(12):3577. doi: 10.3390/jcm13123577.
: Arterio-venous fistulas (AVF) are used as first-line access for hemodialysis (HD) in the pediatric population. The aim of this investigation was to describe a single-center experience in the creation of AVF, together with its patency in children. : This single-center retrospective study included all patients aged ≤18 years with AVFs created between 1993 and 2023. The collected data included patients' demographics, hemodialysis history, intraoperative data, and required reinterventions in order to determine the impact of these variables on primary, primary-assisted, and secondary patency. : Fifty-seven patients were analyzed with a median age of 15 years (range, 7-18 years). Fifty-four forearm and four upper arm fistulas were performed. The median follow-up was 6.9 years (range, 0-23 years). The primary failure rate was 10.5%. The primary patency rate was 67.6%, 53.6%, 51.4%, and 38.1% after 1, 3, 5, and 10 years; primary-assisted patency was 72.9%, 62.8%, 60.6%, and 41.5%; and secondary patency was 87.3%, 81.3%, 76.8%, and 66.6% after 1, 3, 5, and 10 years in the studied population. : AVFs showed an acceptable rate of primary failure and excellent long-term patency. In this context, AVFs are an appropriate option for HD access, especially in pediatric patients.
动静脉内瘘（AVF）被用作儿科人群血液透析（HD）的一线通路。本研究的目的是描述单中心创建AVF的经验及其在儿童中的通畅情况。：这项单中心回顾性研究纳入了1993年至2023年间创建AVF的所有年龄≤18岁的患者。收集的数据包括患者的人口统计学信息、血液透析史、术中数据以及所需的再次干预措施，以确定这些变量对初次、初次辅助和二次通畅的影响。：对57例患者进行了分析，中位年龄为15岁（范围7 - 18岁）。共进行了54例前臂和4例上臂内瘘手术。中位随访时间为6.9年（范围0 - 23年）。初次失败率为10.5%。在研究人群中，1年、3年、5年和10年后的初次通畅率分别为67.6%、53.6%、51.4%和38.1%；初次辅助通畅率分别为72.9%、62.8%、60.6%和41.5%；二次通畅率分别为87.3%、81.3%、76.8%和66.6%。：AVF显示出可接受的初次失败率和出色的长期通畅率。在此背景下，AVF是HD通路的合适选择，尤其是在儿科患者中。
