PATENCY RATE OF BRACHIOCEPHALIC VS RADIOCEPHALIC AVF IN CHRONIC KIDNEY DISEASE PATIENTS IN POPULATION OF D.I.KHAN DIVISION, PAKISTAN.

Background: All patients with chronic renal failure need vascular access for hemodialysis that is possible with CVP line but it shorter life. The most suitable and effective vascular access on long term basis is the creation of arteriovenous fistula (AVF). The objective of this study was to compare the patency rate of Radiocephalic vs. Brachiocephalic AVFs in population of D.I.Khan division, Pakistan. Materials & Methods: This randomized control trail was conducted in Department of Surgery Gomal Medical College, D.I.Khan, Pakistan from January 2017 to December 2019. 266 patients were equally randomly allocated into Brachiocephalic AVF (BCAVF) and Radiocephalic AVF (RCAVF). Sex, age groups and patency of AVT were nominal variables. Data for sample was described by count & percentages and for population as confidence interval at 80% confidence level. McNemar chi-square test was used to test hypothesis to compare patency rate of Brachiocephalic AVF vs. Radiocephalic AVF. Results: Patency was present in 129 (97%, 80% CI 94.45-98.39%) and absent in four (3%, 80% CI 1.61-5.55%) cases in Brachiocephalic, while it was present in 107 (80.5%, 80% CI 76.04-84.86%) cases and absent in 26 (19.5%, 80% CI 15.52-24.32%) cases in Radiocephalic AVF group. McNemar chi-square test showed p <.0001, so the null hypothesis was rejected, showing higher patency rate in BCAVF. Conclusion: Brachiocephalic AVF creation is more ideal in terms of patency and maturation as compare to Radiocephalic AVF because of increased vessel diameter and increased arterial pressure at proximal site below elbow joint. [ABSTRACT FROM AUTHOR]