Outcomes of patients commencing peritoneal dialysis with and without back-up arteriovenous fistulas.
Transitions from peritoneal dialysis (PD) to haemodialysis (HD) are often unpredictable and central venous catheters (CVCs) are frequently required. Early studies found few back-up arteriovenous fistulas (bAVFs) were ever used. The PD population’s characteristics have changed over time which may have altered the likelihood of bAVFs being used. This study aimed to report use of, and outcomes associated with, bAVFs in a contemporary cohort of peritoneal dialysis patients.A single-centre, retrospective study of PD patients commencing dialysis between 2006-2016, stratified according to presence/absence of bAVF.One hundred seventy-six patients were included-82 with bAVF, 94 without bAVF-of whom 156 transitioned off PD. Transitions were to HD (49%), transplantation (23%), death (15%) and renal-recovery (1%). 51% of bAVFs were successfully used and 82% of bAVFs were patent when required. Median time from creation to bAVF use was 2.5 years. More patients with a bAVF transitioned to HD (62 vs 38%, p