(1) Background: Arterio-venous fistulas (AVFs) are considered the gold-standard vascular access (VA) in patients on maintenance hemodialysis (HD) therapy. AVF calcifications represent a less studied VA related complication, even though HD patients are at a higher risk for extraosseous calcifications. The aim of this study is to assess the prevalence and risk factors of AVF calcifications, as well as the 5-year impact on AVF functionality and on overall mortality. (2) Methods: We conducted a 5-year prospective study including 161 patients on maintenance HD therapy. At baseline, we collected data related to VA history, comorbidities, demographics, subjective global assessment scale (SGA), and biochemical parameters. All patients underwent a complete AVF ultrasound and we recorded AVF blood flow and the presence of AVF calcifications, stenoses, and aneurysms. (3) Results: In our study, we found an AVF calcification prevalence of 39%. In a univariate analysis, we found that patients with AVF calcifications were associated with other AVF complications as well (stenoses, aneurysms), had longer AVF and HD vintage, as well as higher serum calcium and PTH values. In a multivariate analysis, we found that patients with a longer HD vintage and higher calcium values were independently associated with AVF calcifications. AVF calcifications did not affect 5-year fistula patency, nor were they associated with a higher mortality risk in our group of patients. (4) Conclusions: AVF calcifications were a frequent finding in our analysis, but their presence does not seem to affect the 5-year AVF patency.

The preservation of complication-free arterio-venous fistulas (AVF) for long-term hemodialysis (HD) use is associated with better overall patient outcomes, which is why this is a current goal in any HD center. Point-of-care ultrasound (POCUS) for in-center AVF assessment has proven its benefits in the identification of vascular access (VA) complications and as an additional tool to avoid blind cannulation. The current study aims to assess the change in the HD nurses’ perceptions regarding AVF POCUS use in the HD center. The nursing staff anonymously answered a Likert scale questionnaire with five questions related to various aspects of AVF POCUS utility shortly after the technique had been implemented and at a 5-year follow-up. The results showed an overall positive attitude toward this method, both at implementation and at follow-up, with no statistically significant score changes for four out of the five items assessed. However, we found a statistically significant reduction in the nurses’ cannulation confidence scores at the 5-year follow-up (p < 0.01). Overall, AVF POCUS implementation is regarded as a useful tool, with major benefits both for the patient and for the medical team. The current study results aim to support the introduction of AVF POCUS assessment as a standard practice from the nursing staff’s viewpoint. This study was not registered.

(1) Background: Arteriovenous fistula (AVF) thrombosis represents a major cause of vascular access failure in patients undergoing maintenance hemodialysis. Identifying early biochemical markers associated with thrombosis may facilitate timely intervention and improve vascular outcomes. This study aimed to evaluate the association between baseline biochemical markers and the risk of AVF thrombosis and mortality during long-term follow-up. (2) Methods: We conducted a prospective observational study involving 249 chronic hemodialysis patients with functional AVFs. Baseline data included intact parathyroid hormone (iPTH), hemoglobin, phosphate, potassium, albumin, dialysis adequacy (Kt/V), age, diabetes status, and antivitamin K (AVK) therapy. Patients were followed for five years for the occurrence of AVF thrombosis and mortality. Statistical analysis was performed using one-way ANOVA with Levene’s test and Scheffé post hoc comparisons. (3) Results: iPTH levels were significantly higher in patients who developed AVF thrombosis (mean 494.6 pg/mL) than in those without thrombosis (mean 381.5 pg/mL; p = 0.047). Other variables, including hemoglobin, phosphate, Kt/V, age, diabetes, and AVK therapy, were not significantly associated with thrombosis. Mortality was more frequent among patients with diabetes mellitus and those receiving antivitamin K therapy; however, only the association with diabetes reached statistical significance. (4) Conclusions: Elevated iPTH was associated with AVF thrombosis. Routine monitoring may help identify high-risk patients and guide timely interventions.