INFECTION OF ARTERIOVENOUS-FISTULAS CREATED FOR CHRONIC-HEMODIALYSIS

One of the complications of chronic haemodialysis is infection at the venous access site. A retrospective chart review (1985-1990) was done on patients requiring venoaccess for haemodialysis. 197 patients had 2 54 arterio-venous (A-V) fistulas created. 40 patients had 71 prostheti c implants and 157 patients had 183 autogenous fistulas created. 16 (2 2%) prosthetic grafts were infected versus 8 (4.3%) autogenous fistula s (p < 0.0001). Bacteraemia was present in 9/16 (56%) infected prosthe tic grafts and 4/8 (50%) infected autogenous fistulas. Seven (43.8%) o f the prosthetic grafts required removal; 6 (37.5%) were cured with dr ainage, irrigation and antibiotics, and 3 (18.8%) with antibiotics alo ne. One (12.5%) of the autogenous fistulas was removed, 4 (50%) requir ed revision and 3 (37.5%) were treated with antibiotics alone. Wheneve r possible, A-V fistulas should be created in the arms with an autogen ous graft as infections are less and easier to treat.