Effect of Aspirin on Maturation of Arteriovenous Fistula Created for Hemodialysis in End Stage Renal Disease Patients

Abstract Background: With the increasing prevalence of End stage renal disease (ESRD) there is a growing need for Hemodialysis (HD). Safe, durable and reliable vascular access is essential for successful HD but failure of maturation continue to present significant barriers to successful fistula use. The study was conducted on 50 patients to assess the effect of aspirin on maturation of radio-cephalic arteriovenous fistula (RC-AVF). Aim of Study: To assess the effect of Aspirin on the maturation of RC-AVF versus non treatment group. Patients and Methods: This study was conducted on fifty ESRD patients who had a RC-AVF in either Ain Shams University Hospitals or El Sahel Teaching Hospital from September 2019 to March 2020. We have included all patients who had an RC-AVF under local anesthesia and the fistula was clinically functioning immediately post operatively. The study is a prospective randomized controlled trial (RCT) comparing Aspirin intake versus no treatment in patients who had a functioning RC-AVF after finishing creation of the fistula. The patients in the first group was given aspirin (ASA) 75mg tablet once daily after AVF creation for six weeks postoperatively, while the patients in the second group did not receive any medication. Results: After Six weeks of follow-up of all patients, maturation occurred in 94 % of patients. The maturation rate in Apirin group was 96%, while it was 92% in control group with a p-value of 0.5743. Access thrombosis has occurred in one patient in the aspirin group and two patients in the control group with a p-value of 0.327. The mean flow volume was 780ml/min ±  127.2 in the aspirin group and 754.4ml/min ±  128.9 in the control group with a p-value = 0.484. The mean vein diameter in aspirin group was 5.86 mm ±  0.342 and that of the control group was 5.992 mm ±  0.287 with a p-value=0.284. Conclusion: Aspirin use was not beneficial for AVF maturation among ESRD patients who undergo a new RC-AVF. That's why practice patterns in this area needs to be improved to limit unbeneficial aspirin use.