An exploratory evidence-mapping review of factors influencing the patency of autogenous arteriovenous fistula in hemodialysis patients

This exploratory evidence-mapping review assessed factors associated with long-term patency of autogenous arteriovenous fistulae (AVFs) in patients undergoing maintenance hemodialysis. Following the PRISMA 2020 guidelines, seven databases were searched from January 2014 to March 2024. We identified 14 eligible sources (5 randomized trials, 1 cohort study, 3 retrospective studies, 3 guidelines, and 2 consensus articles), which were summarized across three main areas, namely patient-related factors, clinical and vascular factors, and care and compliance factors. The results showed that low serum protein/poor nutrition, infection and thrombosis were associated with AVF failure, while standardized nursing care, appropriate drug management, surgical technique and good adherence to postoperative instructions led to better patency. Pooled results suggested a higher failure risk with hypoproteinemia and older age. Overall, AVF patency is influenced by multiple factors, several of which are modifiable through nutrition support, infection prevention, thrombosis surveillance, and structured follow-up care. Registration: CRD420251039785