Evaluation and Patterns of Vascular Access among Chronic Kidney Disease Patients on Maintenance Haemodialysis in a Tertiary Hospital in Nigeria: A Retrospective Descriptive Study

Abstract

Introduction: Haemodialysis vascular access is pivotal as it impacts on the quality of care of chronic kidney disease patients, and guidelines recommend arteriovenous fistula (AVF) as the preferred access route for better outcomes. However, in resource-limited settings, there are challenges associated with creation of AVF, leading to heavy reliance in the use of central venous catheters (CVCs) for haemodialysis. Aim: The main objective of this study is to determine the patterns of vascular access among chronic kidney disease (CKD) patients on maintenance haemodialysis (HD). Methods: A hospital-based retrospective, descriptive study was conducted among 544 CKD patients on maintenance HD at the dialysis centre of the University of BeninTeaching Hospital (UBTH). Data was manually collected from the medical records of patients who received HD treatment over a period of 3 years. Data were analyzed using descriptive statistics, and presented as tables and charts. Results: Among the CKD patients, there were more males (59.3%) as compared to females (40.7%), and the mean age of the study population was 43.1±16.8 years. There was a high prevalent use of central venous catheters (97.0%) for HD, and femoral catheters (95.6%) were most commonly used compared to the other catheters. Only a very small proportion used AVF (3.0%), however, there was an increasing trend in the use of AVF from 18.8% to 81.2% and a decreasing trend in CVCs use from 37.5% to 29.5%. Chronic glomerulonephritis (40.9%) was the commonest cause of CKD that necessitated the initiation of HD. Conclusion: Our study highlighted the prevalent use of central venous catheters as the primary vascular access method for CKD patients on maintenance hemodialysis. These findings underscore the urgent need to improve access to AVF and enhance vascular access management, ultimately optimizing patient outcomes in resource-limited settings.