الفهرس 
Vascular Access for Hemodialysis and theirOnly 14 pages are availabe for public view
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Abstract
Introduction: One of the common treatment options of patients suffering from end-stage renal disease is hemodialysis. Hemodialysis is usually done through a vascular access route, ie, arteriovenous fistula (AVF). Arteriovenous fistula is a nonphysiologic vascular access which is imposed on cardiovascular system.
Aim of the Work: To determine prevalence of high flow Access in hemodialysis patients. To study the relation of high flow access with high cardiac output failure.
Patients and Methods: This cross sectional study was conducted on 97 chronic hemodialysis patients who are receiving their treatment at Ain Shams University Hospital Dialysis Unit.
Results: All ESRD Patients receiving chronic HD treatments at Ain Shams University dialysis unit were screened for eligibility during the study period. A total of 178 patients were listed as per hospital records, 50 patients of them refused to participate in the study giving an 72% response rate. Of the remaining 128 patients, 97 patients met the study inclusion criteria while 31 were excluded as per study protocol. Thus, a total of 97 patients were eligible to participate in the study All of them were recruited. There was also a significant difference in SPAP between both study groups; however, no significant difference was observed in RV function as indicated by TAPSE.
Conclusion: High flow access is a major complication of AVF in ESRD with catastrophic effect on the heart. AVF Qa of more than 2 liters per minutes showed increased risk of High cardiac output heart failure this affection of the heart appears in the form of changes in left ventricle and left atrial diameters and volumes with deterioration if left ventricular ejection fraction however right ventricular function despite deterioration markedly it is mainly due volume overload and not correlated to the HFA.
Recommendations: We recommend regular follow up of patients with ESRD for flow within the AVF using Doppler every 3 months at least to ensure flow within the fistula does not exceed 2000 ml/ minutes so early detection of HFA could be done to prevent its complications .