Comparison of Six-Month Patency Rate in Ulnar-Basilic Fistula and Radio-Cephalic Fistula for Hemodialysis Access

Background and Objectives: There are different types of vascular access. We compared the patency rate in Ulnar-Basilic fistula and Radio-Cephalic fistula for vascular access in hemodialysis patients for six months. Methods: The study was performed on 60 patients (aged 50.6±13.5 years) with end-stage renal failure undergoing hemodialysis within 2012-2014 in Imam Ali Hospital in Zahedan, Iran. The patients were divided into two groups. The first group was established anastomosis of wrist radial artery and the cephalic vein and in the second group between ulnar artery and basilic vein in the forearm. Both groups were followed up with respect to patency of the fistula for six-months. Findings: The mean duration of renal failure requiring transplantation among patients was 1.4±1.0 years. The frequency of patency after six months in Ulnar-Basilic fistulas was less than that in the Radio-Cephalic group; however, the difference was not significant (76% vs. 70%, P > 0.05). All fistulas in the two groups showed thrill, except one patient (3.3%) in the Ulnar-Basilic group (primary failure). Hypertension was detected in one patient in the Radio-Cephalic group. Moreover, hematoma was observed in two patients in the Ulnar-Basilic and in two patients in the Radio-Cephalic group, and thrombosis was observed in two patients in the Ulnar-Basilic and in a single patient in the Radio-Cephalic group. Aneurism was observed in three patients (10%) in the Ulnar-Basilic and in four patients in the Radio-Cephalic fistulas. The steal syndrome was observed in two patients in the Radio- Cephalic group, and infection was seen in one patient (3.3%) in the Ulnar-Basilic group and in four patients (13.3%) in the Radio-Cephalic group. Conclusions: Fistula patency rates were comparable in both groups, and there was no significant evidence of postoperative complication difference between the two groups.