Photo Credit: Jitendra Jadhav

The following is a summary of “Impact of arteriovenous fistula aneurysms on a UK dialysis populations’ perception of vascular access,” published in the September 2024 issue of Nephrology by Khawaja et al.

Clinical outcome measures often overlook factors that matter to patients. There is a growing push from guideline bodies for a more patient-centered approach.

Researchers conducted a retrospective study exploring how aneurysms in arteriovenous fistulas (AVF) affect patients’ perceptions.

They administered the Vascular Access Questionnaire (VAQ) to hemodialysis patients across 10 units between April 2017 and 2018 as a part of a quality improvement project. Data from patients with aneurysmal AVFs, classified by Valenti et al., were reviewed and compared to the broader group.

The results showed that out of 539 patients (median age 66, 59% male) included in the study, 195 had aneurysmal AVFs, with Type 2 being the most common (75%). Aneurysms developed significantly with AVF duration: 11% after 1 year, 43% after 5 years, and 61% after 10 years. Patients with diabetes had fewer aneurysms than non-diabetics (25% vs. 43%, P<0.001). VAQ scores did not vary significantly by aneurysm than non-diabetics (P=0.816) or morphology (P=0.277), but patients with aneurysms were more concerned about appearance (P<0.001). Despite this, they reported higher satisfaction, ease of use, and lower bruising and clotting (P<0.05%).

Investigators concluded that despite concerns about aneurysmal AVFs, patients reported high satisfaction levels. This insight could help clinicians emphasize the positive aspects of aneurysmal AVFs during preprocedural discussions with patients.

Source: bmcnephrol.biomedcentral.com/articles/10.1186/s12882-024-03737-1