Knowledge, Attitude, and Perceived Barriers of Arteriovenous Fistula among Chronic Kidney Disease Patients Attending a Tertiary Care Center

Introduction: Chronic kidney disease (CKD) affects 11% of the adult population worldwide. Hemodialysis (HD) therapy can be through either arteriovenous fistula (AVF), arteriovenous graft, or central venous catheter. Although AVF has better outcomes, many factors are responsible for its underutilization. Materials and Methods: A cross-sectional study was conducted in a tertiary care hospital among all adult patients diagnosed with CKD registered in the nephrology outpatient department for 3 months. The patients were subjected to a structured questionnaire. The questionnaire consisted of four parts, namely sociodemographic details, patients’ knowledge regarding AVF, attitude toward AVF, and perceived barriers toward the procedure. Data were analyzed using SPSS V-21. Demographic and knowledge data were summarized by calculating means and standard deviation. Attitudes and perceived barriers were analyzed as categorical variables. Association between categorical variables was done using the Chi-square test. Results: The mean age of the study participants was 52.24 (±15.47) years. The major cause of end-stage renal disease was hypertension (35.3%). Adequate knowledge was found to be among 79.8% of patients; which was significantly associated with patients who had dialysis session >150 times and who underwent AVF. 65.5% of patients would recommend AVF to others who are undergoing HD. Fear of needles (18%) was found as a major barrier to undergoing AVF. Conclusion: A systematic health education regarding the advantages of AVF over other VA methods can be done before initiating HD which can reduce the perceived barriers. This will aid in increasing the acceptance of AVF procedure among CKD patients.