الفهرس 
Introduction and RationaleOnly 14 pages are availabe for public view
 |  | from | 154 |  |  |
| | | from | 154 | | |
Abstract
chronic kidney disease is a worldwide public health problem. In the United States, there is a rising incidence and prevalence of kidney failure, with poor outcomes and high cost. There is an even higher prevalence of earlier stages of chronic kidney disease.
Construction of an AVF creates conditions for increasing the flow of blood through the venous system. Fulfillment of these conditions reduces the risk of turbulence and endothelium injury, which, in turn, minimizes the potential for stenosis. An AVF is closest to the ideal model of vascular access. The most important complications of fistulae for hemodialysis (HD) are lymphedema, infection, aneurysm, stenosis, congestive heart failure, steal syndrome, ischemic neuropathy and thrombosis.
Since there are only few studies discussed the causative possibility of the AVF to the LVH and HD associated heart failure, and since there are no significant studies discussed the possible correlation between the location of the AVF and the RV abnormalities in the HD patients, this study is aimed for studying this possible correlation between AVF’s location and development of the right ventricle (RV) abnormalities in CKD patients.
Our study is an interventional study, included fifty adult ESRD patients decided to start hemodialysis through an AVF divided into 2 equal groups, one group consists of 25 patients who had brachial approach AVF and another group consists of 25 patients who had radial approach AVF recruited from vascular surgery department in Suez Canal university hospital and Ismailia general hospital, Ismailia. Patients had 2 echocardiographic studies assessing the RV, the first study was done just a few hours before the AVF operation, and the second study was done 3 months after the AVF operation. Both studies were conducted after hemodialysis (HD) session which lasted 3 hours at least. The exclusion