Report of Native Arteriovenous Fistulas on End Stage of Chronic Kidney Disease Patients in Indonesia

Abstract

Introduction: Most CKD patients in the early stages are difficult to diagnose, so patients were found in the advanced stage of CKD. At this stage, treatment options only fall on hemodialysis and kidney transplantation. AV-shunt is indicated when long-term hemodialysis is required. Distal AV-shunt is an AV-shunt that is often used. This study aims to observe the proportion and characteristics of CKD stage V patients undergoing AV-shunt. Method: This research is a retrospective descriptive study describing the data of patients with CKD who underwent the procedure of AV-shunt installation from the medical record department of RSUP Dr. Wahidin Sudirohusodo Makassar during the period January 2017 to December 2018. From the data obtained, it was recorded gender, age, number of CKD patients, number of CKD patients undergoing AV-shunt, postoperative complications, surgical failure, and pre comorbid factors of CKD patients (Diabetes Mellitus and Uric Acid). Results: The results of this study show the facts in 2 years of observation, there were 327 people affected by CKD in Dr. Wahidin Sudirohusodo, and only 40.97% of patients who underwent the AV-shunt procedure. CKD sufferers were dominated by male sex (n = 204; 62.4%) compared to female (n = 123; 37.6%). In percentage, male patients underwent AV- shunt (44%) greater than females (37%). Complications were found in 13 (10%) patients. A surgical failure occurred in 13 cases (9.7%). Patients Diabetes mellitus is a major pre- comorbid factor found in 65% of patients, and Hyperuricemia is also found in 38.5% of patients. Conclusion: From 327 patients CKD, only 134 patients underwent the AV-shunt procedure. CKD sufferers are dominated by the male gender. Most complications are bleeding and infection. Diabetes Mellitus is the leading precomorbidity factor most commonly found. Keywords: AV-shunt, CKD Stage V, Diabetes Mellitus, Uric Acid