Comparative Study of Distal Radiocephalic Fistulas Versus Brachiocephalic Fistulas in Chronic Kidney Disease Patients: A Single-Center Study in Bangladesh
DOI:
https://doi.org/10.64149/J.Carcinog.24.10s.606-610Keywords:
Arteriovenous Fistula, Brachiocephalic, CKD, Hemodialysis, Radiocephalic, Thrombosis.Abstract
Background: Arteriovenous fistulas (AVFs) are the preferred vascular access for hemodialysis in chronic kidney disease (CKD) patients. Distal radiocephalic (DRC) and brachiocephalic (BC) fistulas are common, but their comparative efficacy remains debated, especially in resource-limited settings like Bangladesh.
Objective: This study compared the outcomes of distal radiocephalic and brachiocephalic fistulas in chronic kidney disease patients at a single center in Bangladesh.
Methods: A prospective comparative study was conducted at Bangladesh Medical University (Ex- BSMMU), Dhaka, from July 2022 to June 2025. Sixty CKD patients (30 DRC, 30 BC) were selected via purposive sampling and randomized. Fistula maturation, patency rates, and complications (e.g., thrombosis, infection, steal syndrome) were evaluated. Data were analyzed using SPSS version 23.0, with p < 0.05 considered statistically significant.
Results: Brachiocephalic fistulas demonstrated superior maturation rates (86.7% vs 73.3%) and shorter maturation time (4.2 vs 6.5 weeks) compared to distal radiocephalic fistulas. However, distal fistulas showed lower thrombosis rates (10% vs 23.3%) and no steal syndrome. Primary patency at 6 months favored brachiocephalic fistulas (80% vs 63.3%), while 12-month secondary patency was comparable (76.7% vs 70%). Blood flow rates were significantly higher in brachiocephalic fistulas (650±120 vs 480±90 mL/min).
Conclusion: While brachiocephalic fistulas offer better maturation and short-term patency, distal radiocephalic fistulas present fewer complications. The choice should consider patient- specific factors, balancing immediate usability with long-term safety in hemodialysis access planning.
