Impact Of High Flow Arteriovenous Fistula In Chronic Hemodialysis Patients On Cardiac Functions

Introduction: High flow access (HFA)is associated with complications like high output heart failure, pulmonary hypertension, massively dilated fistula, dialysis associated steal syndrome or distal hypoperfusion ischemic syndrome (DHIS).Aim of study: to determine the impact of high flow arteriovenous fistula in chronic hemodialysis patients on cardiac structures and functions.Subjects and Methods: 59 patients were included in the study divided into two groups: Group A: 43 patients (non-HFA group with Qa < 2000 ml/min), and Group B: 16 patients (HFA group with Qa > 2000 ml/min).Results: Prevalence of HFA among study population was 27%. Mean AVF Qa was 1039.5±209.5 and 5560.5±3184.1 ml/min, for group A and B respectively. A significantly lower LV ejection fraction [EF] was observed in group B with a mean value of 56.3± 11.4% versus 64.4 ± 3.6%.Conclusions: High flow arteriovenous fistula (HFA) is a prevalent hemodialysis vascular access problem affecting about 27% of chronic hemodialysis patients. HFA was associated with a significant effect on both systolic and diastolic functions of heart.