Analysis of risk factors for late arteriovenous fistula failure and patency rates after angioplasty in hemodialysis patients: a retrospective cohort study

作者全名：Long, Jie; Chen, Huan; Huang, Qi; Chen, Xiaojing; Ellis, Robert J.; Zanoli, Luca; Mussap, Michele; Zhu, Changliang

作者地址：[Long, Jie; Chen, Huan; Chen, Xiaojing] Xi An Jiao Tong Univ, Honghui Hosp, Dept Nephrol, Xian, Peoples R China; [Huang, Qi] Chongqing Med Univ, Affiliated Hosp 2, Dept Neurosurg, Chongqing, Peoples R China; [Ellis, Robert J.] Univ Queensland, Fac Med, Brisbane, Australia; [Zanoli, Luca] Univ Catania, Dept Clin & Expt Med, Policlin Univ, Catania, Italy; [Mussap, Michele] Univ Cagliari, Sch Med, Dept Surg Sci, Lab Unit, Cagliari, Italy; [Zhu, Changliang] Xi An Jiao Tong Univ, Honghui Hosp, Dept Intens Care Unit, 555 Youyi East Rd, Xian 710054, Peoples R China

通信作者：Zhu, CL (通讯作者)，Xi An Jiao Tong Univ, Honghui Hosp, Dept Intens Care Unit, 555 Youyi East Rd, Xian 710054, Peoples R China.

来源：TRANSLATIONAL ANDROLOGY AND UROLOGY

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:001222044900011

JCR分区：Q3

影响因子：1.9

年份：2024

卷号：13

期号：2

开始页：209

结束页：217

文献类型：Article

关键词：Chronic kidney disease (CKD); end-stage kidney disease (ESKD); hemodialysis (HD); arteriovenous fistula (AVF); failure

摘要：Background: The incidence of chronic kidney disease (CKD) and end -stage kidney disease (ESKD) is increasing worldwide. Hemodialysis (HD) is the mainstay of renal replacement therapy for patients with ESKD. Risk factors associated with late arteriovenous fistula (AVF) failure in HD patients are poorly investigated. Therefore, the aim of this study was to identify factors associated with late AVF failure in HD patients. Methods: Patients with end -stage renal disease (ESRD) who underwent forearm or upper arm AVF angioplasty at Second Affiliated Hospital of Chongqing Medical University between September 2009 and August 2018 were included. Patients were followed up for 36 months. Baseline characteristics were collected using electronic medical records (EMRs). Variables associated with late AVF failure were identified using Cox proportional hazards models. Results: There were 137 patients (64% male, 36% female) included in this study, with 50 (36.5%) experiencing AVF failure. Univariable log -rank analysis showed that age, C -reactive protein (CRP), erythrocyte sedimentation rate (ESR), intact parathyroid hormone (iPTH), albumin (ALB), and AVF patency rate were significantly different between patients who did and did not experience AVF failure. Cox regression analysis showed that CRP [P=0.002, hazard ratio (HR) =2.719, 95% confidence interval (CI) for HR: 1.432-5.164], ESR (P=0.030, HR =2.431, 95% CI: 1.088-5.434), iPTH (P=0.013, HR =0.325, 95% CI: 0.133-0.793), and ALB (P=0.040, HR =0.539, 95% CI: 0.299-0.972) were independently associated with AVF failure. Kaplan -Meier survival analysis showed that the cumulative patency rates of AVF at 6, 12, 18, 24, 30, and 36 months were 84%, 74%, 69%, 64%, 64%, and 64%, respectively. Conclusions: CRP, ESR, iPTH, and ALB were associated with AVF failure and should be used as reference in clinical practice.

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