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Diagnostic validity of CAVeA2T2 score in predicting failure of radiocephalic arteriovenal fistula in terminal stage renal failure patients at Sanglah Hospital, Bali, Indonesia

  • Ardi Juanda ,
  • Ketut Putu Yasa ,
  • I Gede Raka Widiana ,


Introduction: Chronic kidney disease (CKD) is a global public health problem with increasing prevalence and incidence and poor prognosis. As a result, more patients will be in terminal stage kidney failure and require placement of vascular access for hemodialysis. Mature and functional arteriovenous fistula (AVF) is considered the best modality for access to hemodialysis. This study aims to examine the CAVeA2T2 scores in predicting failure of arteriovenous fistula radiocephalic, significant factors related to failure of arteriovenous fistula so that it can be used to predict failure using a scoring system to predict primary failure and secondary failure fistula.

Methods: A cross-sectional study was carried out at Sanglah Hospital, Bali, Indonesia, during the study period. This study using diagnostic test evaluation method using ROC curve analysis on months 1 and 3, a total of 50 populations obtained using Purposive sampling quota period April 2018 - December 2018 and failure of Hemodialysis as gold standard. Data were analyzed using Stata version 12 for Windows.

Results: Results of the CAVeA2T2 score where the maximum score of 7 was analyzed using the ROC curve, the cutoff point was obtained at month 1 ≥5 with AUC 0.8987 and at 3 months ≥ 4 with AUC 0.3966 sensitivity and specificity CAVeA2T2 score of 91.3% and 75% in month 1, in the 3rd month 85.7% and 87.5% were obtained.

Conclusion: Sensitivity and specificity values that provide a good value so that the CAVeA2T2 score can be used to predict failure of arteriovenous radiocephalic fistulas.


  1. National Kidney Foundation. Kidney Disease Outcomes Quality Initiative (NKF K/DOQI). Clinical practice guidelines for vascular access. America Journal Kidney Disease. 2001.
  2. Muray Cases S, García Medina J, Pérez Abad JM, Andreu Muñoz AJ, Ramos Carrasco F, Pérez Pérez A et al. Importance of Monitoring Treatment of Failred Maturation in Radiocephalic Arteriovenous fistula in predialysis: role of ultrasound. Nefrologia. 2016;36(4):410-417.
  3. Bosanquet DC, Rubasingham J, Imam M, Woolgar JD, Davies CG.. Predicting outcomes in native AV forearm radio-chepalic fistulae; the CAVeA2T2 scoring system. J Vasc Access. 2015;16(1):19-25.
  4. Martinez LI, Esteve V, Yeste M, Artigas V, Llagostera S. Clinical Utility of A New Predicting Score for Radiocephalic Arteriovenous Fistula Survival. Ann Vasc Surg. 2017;41:56-61.
  5. Roy-Chaudhury P, Arend L, Zhang J, Krishnamoorthy M, Wang Y, Banerjee R, et al. Neointimal Hyperplasia in early arteriovenous fistula failure. Am J Kidney Dis. 2007;50(5):782-90.
  6. Khavanin Zadeh M, Gholipour F, Naderpour Z, Porfakharan M. Relationship between Vessel Diameter and Time to Maturation of Arteriovenous Fistula for Hemodialysis Access. Int J Nephrol. 2012;2012:942950.
  7. Shingarev R, Barker-Finkel J, Allon M.. Association of hemodyalisis central venous catheter use with ipsilateral arteriovenous vascular access survival. Am J Kidney Dis. 2013;60(6):983-9.
  8. Dorobantu LF, Stiru O, Bulescu C, Bubenek S. The Brachio-Brachial Arteriovenous Fistula, Technical Problems in Patients on Hemodialysis, Maria Goretti Penido, IntechOpen. 2011. DOI: 10.5772/22608. Available from:
  9. Ferring MM. An Investigation into Factor Predicting Patency and Maturation of Arteriovenous fistula Used for Haemodialysis in End Stage Renal Disease. E-theses respiratory. Birmingham: University of Birmingham. 2012.
  10. Miller PE, Tolwani A, Luscy CP, Deierhoi MH, Bailey R, Redden DT, et al. Predictors of adequacy of arteriovenous fistulas in hemodialysis patients. Kidney Int. 1999;56(1):275-80.
  11. Monroy-Cuadros M, Yilmaz S, Salazar-Bañuelos A, Doig C. Risk factors associated with patency loss of hemodialysis vascular access within 6 months. Clin J Am Soc Nephrol. 2013;5(10):1787-92.
  12. Woods JD, Turenne MN, Strawderman RL, Young EW, Hirth RA, Port FK, et al. Vascular access survival among incident hemodialysis patients in the United States. Am J Kidney Dis. 1997;30(1):50-7.
  13. Sari F, Taskapan H, Sigirci A, Akpinar B. Evaluations of Risk Factor for Arteriovenous Fistula Failure in Patients undergoing Hemodialysis. Erciyes Med J. 2016;38(1):12-19.
  14. Smith GE, Gohil R, Chetter IC.. Factors Affecting the patency of arteriovenous fistulas for dialisis. J Vasc Surg. 2012;55(3):849-55.

How to Cite

Juanda, A., Yasa, K. P., & Widiana, I. G. R. (2019). Diagnostic validity of CAVeA2T2 score in predicting failure of radiocephalic arteriovenal fistula in terminal stage renal failure patients at Sanglah Hospital, Bali, Indonesia. Bali Medical Journal, 8(3), S807-S811.




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