الفهرس 
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Abstract
N
o doubt that native AVF is the vascular access of choice for patients who require hemodialysis NKF-DOQI suggested parameters as criteria for a good functioning AVF (rule of 6’).
The aim of this study is evaluating the effect of depth of cephalic vein in mature Brachiocephalic arteriovenous fistula as regards easy needling and patency as well as complications.
A Prospective cohort study of adult end-stage renal disease patients with mature brachiocephalic arteriovenous fistula after fulfilling the inclusion and exclusion criteria over 6 months follow up period after creation of the access who were allocated non randomly into two groups (superficial and deep mature cephalic vein with cut off value of 6 mm).
During the study period, 50 patients, divided into 2 groups A&B including 25 patients per group, group A (18 males and 7 females) while group B (5 males and 20 females). Age of patients in group A (mean= 43.16 ± 11.61) while in group B (mean= 47.32 ± 9.81). Diabetic patients represented 44% in both groups while hypertensive patients were ranging between 60% and 68% in group A and B respectively. No patients in group A suffered from coronary artery disease (CAD) while only 4% in group B suffer from CAD. About 10% had history of previous AVF in both groups. Mean body mass index (BMI)in group A about 23.23 ± 2.05 while in group B is about 28.49 ± 1.39 that means all group B suffer from being overweight (P-value< 0.01).
There is a significant difference between two groups as regard depth all over observation period (P-value< 0.01) with no significant difference between two groups as regard diameter and flow velocity. During follow up we found that there is a highly significant difference in complications of both groups during dialysis procedure being more in group B (P-value< 0.01).
Deep seated mature cephalic vein is more liable to complication as hematoma and needling difficulties than superficial one and it’s better to think about efficiency of vein superficialization as well as more efficient options for such superficialization and BMI cutoff value for candidates who are indicated for such procedures.