Causes of Delay in Establishing Permanent Vascular Access in Hemodialysis Patients in Iran

Abstract

Introduction: In End Stage Renal Disease (ESRD), the patient needs alternative treatments such as dialysis for survival. To perform hemodialysis, proper vascular access is required. At emergency situations, the Central Venous Catheters (CVC) are used; however, they are not ideal for long-term dialysis. Hence, the permanent methods of hemodialysis should be replaced as soon as possible. This study aimed to investigate the causes of delay in the establishment of permanent vascular access in patients undergoing hemodialysis in Guilan in 2014 to 2015.

Methods: The study was performed on 420 patients with ESRD who had been undergone hemodialysis through a CVC for more than three weeks in Razi Educational Remedial and Research Center. Data collection was done through checklist and interviews with the patients. All information entered into the SPSS 21 and analyzed by descriptive and inferential tests.

Results: Totally, 56.4% of patients were male and 25.5% were 61 to 70 years old. 42.1% had delay between 1 and 2 months. The most important predictors of delay were: Patient's unwillingness, high costs of surgery, patient's inadequate knowledge about the need to establish AVF (Arterio Venous Fistula), Patient's fear of risks of AVF, lack of proper insurance coverage, Old age, Lesions at the insertion site of vascular access and lack of access to a nephrologist.

Conclusion: Promoting the patients scientific information about establishing a permanent vascular access can have a significant role in reducing the delays in establishing permanent vascular access.