Adjuvant heparinization before manipulation of artery reduces early failure in primary arteriovenous fistula for end-stage renal disease patients

Nishida, Hayato; Fukuhara, Hiroki; Nawano, Takaaki; Kanno, Hidenori; Yagi, Mayu; Yamagishi, Atsushi; Sakurai, Toshihiko; Naito, Sei; Kato, Tomoyuki; Kudo, Kosuke; Ichikawa, Kazunobu; Tsuchiya, Norihiko

doi:10.1007/s10157-021-02109-5

Cited by 2 publications

(2 citation statements)

References 19 publications

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“…Therefore, further research into the risk factors of AVF failure in HD patients is necessary. At present, some studies have reported on AVF early maturation failure, but the results cannot be considered consistent ( 8 - 10 ). This study aimed to investigate the potential risk factors for late AVF failure which could be used to identify patients at higher risk of AVF failure.…”

Section: Introductionmentioning

confidence: 84%

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

Long,

Chen,

Huang

et al. 2024

Transl Androl Urol

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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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Section: Introductionmentioning

confidence: 84%

“…AVF failure reduces the dialysis efficiency and quality of life of HD patients, and can be life threatening. A survey found that as high as 20–25% of HD patients were hospitalized due to AVF failure ( 10 ). Therefore, further research into the risk factors of AVF failure in HD patients is necessary.…”

Section: Introductionmentioning

confidence: 99%

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

Long,

Chen,

Huang

et al. 2024

Transl Androl Urol

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A Retrospective Case-Control Study on Late Failure of Arteriovenous Fistula in Hemodialysis Patients and Prediction of Risk Factors

Rao

2022

Computational and Mathematical Methods in Medicine

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Objective. A retrospective case-control study was conducted to explore the risk factors of late failure of arteriovenous fistula in hemodialysis patients. Methods. A total of 95 hemodialysis patients treated in our hospital from January 2018 to January 2021 were included. The HE staining results of late failure of arteriovenous fistula in hemodialysis patients were observed. The general data and laboratory indexes of the patients were recorded by using a questionnaire survey, hospital case system, and hemodialysis record. According to the functional status of internal fistula, the patients were divided into two groups: failure group ( n = 35 ) and patency group ( n = 60 ). SPSS22.0 software was employed for statistical analysis, and the relevant data of the two groups were compared. The independent sample t -test was employed for the comparison of variance between groups, and the χ 2 test was employed for counting data. Logistic multivariate regression was employed to analyze the risk factors of late loss of power in autologous arteriovenous fistula (AVF). Results. (1) Late failure of arteriovenous fistula in hemodialysis patients: the results of HE staining showed the following: (1) histological changes of venous intima: 100% of the patients had varying degrees of intimal hyperplasia, mainly eccentric hyperplasia, resulting in luminal stenosis, and annular uniform intimal hyperplasia in some patients, and (2) histological changes of venous media: 81.6% of the patients had venous media lesions, which were mainly in two cases; one was media smooth muscle hyperplasia with fibrous tissue hyperplasia, and the other was smooth muscle compression when intimal hyperplasia was serious, resulting in smooth muscle fiber rupture, disarrangement, focal necrosis, atrophy, and thinning, and some smooth muscle stroma showed vitreous degeneration and myxoid degeneration. A few cases showed multifocal neutrophil, lymphocyte, and plasma cell infiltration. (2) First of all, we surveyed the general data, and there were significant differences in age, history of diabetes, history of hypertension, and uric acid nephropathy ( P < 0.05 ). There was no significant difference in sex, body mass index, smoking history, polycystic kidney disease, chronic glomerulonephritis, and obstructive nephropathy between the two groups ( P > 0.05 ). Secondly, we compared the levels of hemoglobin, eosinophils, platelet count, and hematocrit. The levels of hemoglobin, eosinophils, and hematocrit in the failure group were higher, and the platelet count was lower compared to that of the unobstructed group ( P < 0.05 ). Furthermore, the calcium and phosphorus product and the level of C-reactive protein (CRP) in the failure group were higher, while the levels of fibrinogen and INR in the unobstructed group were lower. The levels of plasma protein, alkaline phosphatase, and cholesterol were higher in the failure group, while the level of triglyceride was lower in the failure group ( P < 0.05 ). Finally, logistic regression analysis showed that age, hemoglobin, hematocrit, and calcium-phosphorus product were the risk factors for late failure of arteriovenous fistula in hemodialysis patients ( P < 0.05 ). There exhibited no significant correlation between diabetes, hypertension, uric acid nephropathy, eosinophil, CRP, fibrinogen, INR, plasma protein, alkaline phosphatase, cholesterol, triglyceride, and late failure of arteriovenous fistula in hemodialysis patients. Conclusion. Age, hemoglobin, hematocrit, and calcium-phosphorus product are independent risk factors for late failure of arteriovenous fistula in hemodialysis patients. The hemoglobin, eosinophil, platelet count, and hematocele in hemodialysis patients with late failure of arteriovenous fistula were higher. The indexes related to biochemistry, blood coagulation, and nutrition were significantly different from those without late failure of arteriovenous fistula. Thus, the risk of late failure of arteriovenous fistula can be predicted.

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Adjuvant heparinization before manipulation of artery reduces early failure in primary arteriovenous fistula for end-stage renal disease patients

Cited by 2 publications

References 19 publications

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

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

A Retrospective Case-Control Study on Late Failure of Arteriovenous Fistula in Hemodialysis Patients and Prediction of Risk Factors

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