PREMIERES PONCTIONS DE FISTULE ARTERIO-VEINEUSE NATIVE CHEZ LES HEMODIALYSES CHRONIQUES A BRAZZAVILLE

Introduction: The arteriovenous fistula (AVF) is the vascular approach of choice recommended in hemodialysis. The objective of our work is to assess the place of AVF in hemodialysis centers in Brazzaville, to determine the complications during the first AVF punctures and their risk factors. Patients and Method: We carried out a cross-sectional, descriptive study in two hemodialysis centers in Brazzaville. The study runs from January 15 to December 31, 2019. Prosthetic AVFs were excluded. The complications that occurred during the first AVF punctures were studied and analyzed with the Epi info software. Results: first AVF punctures were performed in 24 patients (57.14% of patients on chronic dialysis). In 17 patients (70.83%) it was a radio-radial AVF and in seven patients (29.17%) a humero-cephalic AVF. The intensity of the puncture pain was 8/10 in nine patients (37.5%) and 7/10 in seven patients (29.17%). Eleven patients (45.83%) developed a complication that caused the hemodialysis session to be adjourned. The complications found are a large hematoma (25%), a hemorrhage in a jet with a pre-shock state (12.5%), a rupture of the AVF (4.17%), an arterial puncture with pulsatile hematoma (4.17 %). The risk factors for the complications found are the humerocephalic site (p <0.05), overweight (p <0.01), an AVF flow rate greater than 1000 ml / min (p <0.05). Conclusion: The use of AVF is still low in our dialysis centers. The first punctures are intensely painful; complications are frequent.