High-flow arteriovenous fistula and hemodynamic consequences at 1 year after kidney transplantation

Introduction There are only scarce data regarding the cardiovascular impact of arteriovenous fistula after kidney transplantation depending on fistula flow. Methods We performed a single-center, prospective, cohort study including 49 patients with a functional fistula at 1 year from kidney transplantation. Patients were convened for a clinical work-up, a biological analysis, a fistula's Doppler ultrasonography and an echocardiography. Main judgment criterion was comparison of echocardiography parameters between patients with relative (fistula flow >1 L/min and a fistula flow/cardiac output ratio >20%), absolute high-flow fistula (fistula flow >2 L/min) and normal-flow fistula. Results High-flow fistula frequency was 69%. Significantly higher left ventricular end-diastolic and systolic diameters were observed in this group compared with the normal-flow fistula group (53 +/- 6 vs. 48 +/- 7 mm; p = 0.04 and 33 +/- 6 vs. 28 +/- 8 mm; p = 0.02) and between the absolute and relative high-flow fistula subgroups (56 +/- 6 vs. 51 +/- 6 mm; p = 0.009 and 35 +/- 6 vs. 31 +/- 5 mm; p = 0.01). The study showed no other significant differences. Conclusions This study showed a significantly higher but not pathological left ventricular end-diastolic and systolic diameters values in patients with high-flow fistula compared with patients with normal-flow fistula and between patients with respectively absolute and relative high-flow fistula.

Automated summary

The study found that patients with high-flow fistula have significantly larger left ventricular end-diastolic and systolic diameters but not at a pathological level compared to patients with normal-flow fistula.