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< Vol. 13 Issue 4 | Oct-Dec 2012 | pp. 409 - 547

Vascular access in patients receiving hemodialysis in Libya

Vascular access in patients receiving hemodialysis in Libya

J Vasc Access 2012; 13(4): 468 - 474

Article Type: ORIGINAL ARTICLE

DOI:10.5301/jva.5000089

Authors

Wiam A. Alashek, Christopher W. McIntyre, Maarten W. Taal

Abstract

Purpose: A native arteriovenous fistula (AVF) represents the optimal form of Vascular Access (VA) for patients receiving hemodialysis (HD). In Libya there are several barriers to AVF creation including lack of adequate preparation for dialysis and surgical services. We aimed to conduct the first comprehensive study of VA utilisation in HD patients in Libya. Methods: A prospective observational study included all adult patients receiving HD treatment in 25 HD facilities in Libya from May 2009 to Nov 2011. Researchers gathered data regarding VA through interviews with staff and patients as well as medical records. Patients with definitive VA were re-interviewed after 1 year. Results: At baseline the majority of patients (91.9%; n=1573) were using permanent VA in the form of AVF or arteriovenous graft. Patients with permanent VA were more likely to be male and less likely to be diabetic than those with CVCs. Most patients had commenced HD using a temporary CVC (91.8%). VA-related complications were: thrombosis (46.7%), aneurysm (22.6%), infection (11.5%) and haemorrhage (10.2%). Incident VA thrombosis was reported by 14.7% in 1 year. Independent risk factors for incident thrombosis were female gender and diabetes. Hospitalisation for VA related complications was reported by 31.4%. Conclusions: Few patients in Libya initiate HD with definitive VA, but most achieve it thereafter. Improved dialysis preparation and increased provision of surgical services are required to increase the proportion of patients initiating HD with definitive VA and should be a priority in rebuilding health services in Libya after the recent conflict.

Article History

  • • Accepted on 17/06/2012
  • • Available online on 27/07/2012
  • • Published in print on 16/01/2013

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Authors

  • Alashek, Wiam A. [PubMed] [Google Scholar]
    School of Graduate Entry Medicine, University of Nottingham, Nottingham - UK and School of Medicine, University of Tripoli, Tripoli - Libya
  • McIntyre, Christopher W. [PubMed] [Google Scholar]
    School of Graduate Entry Medicine, University of Nottingham, Nottingham - UK and Department of Renal Medicine, Derby Hospitals NHS Foundation Trust, Derby - UK
  • Taal, Maarten W. [PubMed] [Google Scholar]
    Department of Renal Medicine, Derby Hospitals NHS Foundation Trust, Derby - UK

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