Meta-analysis compares outcomes of lower-extremity hemodialysis access types

A systematic review and meta-analysis of 45 studies examined patency, complications, and mortality after surgically created lower-extremity hemodialysis vascular access. Pooled primary patency declined over time while secondary patency remained higher, and autogenous arteriovenous fistula/femoral vein transposition showed higher 12-month primary and secondary patency and lower infection rates than prosthetic arteriovenous grafts. The authors note the evidence is observational and heterogeneous, requiring cautious interpretation.

Most relevant for: Patients requiring hemodialysis access after failure or anatomical unsuitability of upper-extremity options.

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