Abandonment of Arteriovenous Access Is Common

Access abandonment after arteriovenous (AV) fistula (AVF) or graft (AVG) creation can pose clinical challenges for patients with end-stage renal disease. Our objective was to track AV access and identify factors that affect its rate. A single institutional database queried all AVF/AVG creations from 2014 2020. Demographics, comorbidities, outcomes were collected. defined as an no longer used in established alternate hemodialysis methods. Risk downstream effects of analyzed. There 678 a mean age 59.6 years; 41.4% female. Cases included 295 (43.5%) brachiocephalic, 170 (25.1%) brachiobasilic, 101 (14.9%) radiocephalic, 41 (6%) forearm AVFs. Prosthetic AVGs 14.2% cases. Tunneled dialysis catheters present at the time 58.1% 180 (26.5%) accesses abandoned throughout study period; these, 45% never matured, 61% required reinterventions, 96% lost primary patency. occurred more often prior (20% vs 12.7%), radiocephalic AVFs (19.4% 13.3%), grafts (5% 1.2%), less brachiocephalic (36.7% 46%) (all P < .05). Freedom abandonment/death 1 5 years 49% 7%, respectively. Survival 94% 66%, respectively, difference seen with/without during this period. associated AVF (hazard ratio [HR]: 1.27, 95% confidence interval [CI]: 1.02-1.58; = .04) chronic obstructive pulmonary disease (HR: 1.36, CI: 1.03-1.81, .03). did not 5-year survival; however, congestive heart failure 2.18, 1.4-3.41), 1.77, 1.08-2.89), 1.05, 1.03-1.07) increased mortality access-site high frequency few AVFs/AVGs being years. Radiocephalic likely be abandoned. long-term survival.