Comparison of Patency in 5- and 6-mm Hemodialysis Grafts

Highlights

• 5-mm grafts were associated with higher BMI, female predominance.

• 5-mm grafts increased primary patency compared with 6-mm grafts.

• 5-mm grafts should be considered in patients with poor blood vessels.

Abstract

Objectives: Arteriovenous grafts (AVGs) are often the mode of vascular access of choice because poor blood vessels in patients hinder the creation of arteriovenous fistulas (AVFs). The present study aimed to compare the characteristics and patency rates between 5-mm and 6-mm straight grafts.

Methods: We analyzed 119 cases involving AVG operations performed at a single center. The cases were divided into 2 groups based on the size of the straight graft, namely 5-mm (62.2%) and 6-mm (37.8%) grafts. The differences in the baseline characteristics, perioperative data, and patency rates between the groups were subsequently analyzed.

Results: Patients who received 5-mm grafts were predominantly female (P = 0.042) and had a higher body mass index (BMI; P = 0.012) than those who received 6-mm grafts. The 5-mm graft group showed increased primary patency (P = 0.035). However, significant intergroup differences were not observed with respect to the secondary patency rates (P = 0.087). A multivariable analysis confirmed that higher BMI (P = 0.022), cause of diabetes mellitus nephropathy (P = 0.015), frequency of the procedure (≥5 times; P = 0.002), and procedure time (P = 0.028) were significant independent variables that affected the primary patency rates.

Conclusions: Five-mm grafts were associated with higher BMI, female predominance, and increased primary patency compared with the 6-mm grafts. Therefore, 5-mm grafts should be considered for patients with poor blood vessels.