Calcification in arteriovenous fistula blood vessels may predict arteriovenous fistula failure: a 5-year follow-up study

Janković, Aleksandar; Damjanović, Tatjana; Djurić, Živka; Marinković, Jelena; Schlieper, Georg; Djuric, Petar; Dragovic, Jelena Tosic; Bulatović, Ana; Mitrović, Miloš; Popović, Jovan; Floege, Jürgen; Dimković, Nada

doi:10.1007/s11255-017-1515-0

Cited by 11 publications

(17 citation statements)

References 35 publications

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“…VA, vascular access; DSA, digital angiography; PTA, percutaneous transluminal angioplasty. (7,16,17).…”

Section: Multivariate Analysismentioning

confidence: 99%

Predictors associated with early and late restenosis of arteriovenous fistulas and grafts after percutaneous transluminal angiography

Zheng¹,

Xie²,

Xie³

et al. 2021

Ann Transl Med

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Background: The objective of this study was to assess postintervention patency and analyze the predictive factors associated with early and late restenosis after intervention in hemodialysis arteriovenous fistulas (AVF) and arteriovenous grafts (AVG).Methods: This study retrospectively analyzed 284 hemodialysis patients who underwent percutaneous transluminal angioplasty (PTA) due to AVF and AVG stenosis. A total of 350 PTA procedures were performed. Clinical, anatomical, biochemical, and technical variables were analyzed. Using univariate and multivariate analyses, we assessed the postintervention patency of PTA by follow-up, and identified the predictive factors taking into account competing risks.Results: Postintervention patency rates at 3, 6, 12, and 24 months were 86.5%, 66.4%, 42.6%, and 29.8%, respectively, with a median patency duration of 11±0.71 months. Kaplan-Meier analysis showed that the patency rate of the AVF group (n=271) was dramatically higher than the AVG group (n=79) at 3, 6, and 12 months after PTA, respectively (88.9% vs. 78.5%, 69.0% vs. 57.4%, 48.8% vs. 20.0%, P<0.01). Cox survival analysis revealed that the factors associated with postintervention patency of AVF included age of fistulas, serum albumin (ALB) levels, location of stenoses, lesion length longer than 2 cm, multiple stenoses, and maximal pressure of dilatation lower than 16 atm. In addition, factors related to postintervention patency of AVG included the presence of diabetes and hypertension, and serum ALB.Conclusions: This study demonstrated that the risk factors associated with postintervention patency of AVF included age of fistulas, lower levels of serum ALB, location of stenoses, lesion length longer than 2 cm, multiple stenoses, and maximal pressure of dilatation lower than 16 atm. In addition, risk factors related to postintervention patency of AVG included the presence of diabetes and lower levels of serum ALB, while the presence of hypertension was found to be a protective factor for reducing patency loss of AVG. Among all these factors, serum ALB and multiple stenoses tended to predict early restenosis, while pressure of dilatation tended to predict late restenosis.

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“…VA, vascular access; DSA, digital angiography; PTA, percutaneous transluminal angioplasty. (7,16,17).…”

Section: Multivariate Analysismentioning

confidence: 99%

Predictors associated with early and late restenosis of arteriovenous fistulas and grafts after percutaneous transluminal angiography

Zheng¹,

Xie²,

Xie³

et al. 2021

Ann Transl Med

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“…A total of 62 (37.1%) original investigations reported gender-associated adjusted risk of having higher prevalence/severity of VC among patients with CKD [40,42,44,47,48,58,[63][64][65]67,68,84,86,88,90,93,95,[100][101][102]106,112,113,116,117,. Among these articles, 17 (27.4%), 40 (64.5%) and 5 (8.1%) included patients with nondialysis CKD, dialysis-dependent CKD, and renal transplant recipients, respectively (Supplementary Table S2).…”

Section: Gender-related Differences In the Adjusted Risk Of Ckd-associated Vc Presence Or Severitymentioning

confidence: 99%

Gender-Related Differences in Chronic Kidney Disease-Associated Vascular Calcification Risk and Potential Risk Mediators: A Scoping Review

Lee

Chang

et al. 2021

Healthcare

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Vascular calcification (VC) involves the deposition of calcium apatite in vascular intima or media. Individuals of advanced age, having diabetes mellitus or chronic kidney disease (CKD) are particularly at risk. The pathogenesis of CKD-associated VC evolves considerably. The core driver is the phenotypic change involving vascular wall constituent cells toward manifestations similar to that undergone by osteoblasts. Gender-related differences are observed regarding the expressions of osteogenesis-regulating effectors, and presumably the prevalence/risk of CKD-associated VC exhibits gender-related differences as well. Despite the wealth of data focusing on gender-related differences in the risk of atherosclerosis, few report whether gender modifies the risk of VC, especially CKD-associated cases. We systematically identified studies of CKD-associated VC or its regulators/modifiers reporting data about gender distributions, and extracted results from 167 articles. A significantly higher risk of CKD-associated VC was observed in males among the majority of original investigations. However, substantial heterogeneity exists, since multiple large-scale studies yielded neutral findings. Differences in gender-related VC risk may result from variations in VC assessment methods, the anatomical segments of interest, study sample size, and even the ethnic origins of participants. From a biological perspective, plausible mediators of gender-related VC differences include body composition discrepancies, alterations involving lipid profiles, inflammatory severity, diversities in matrix Gla protein (MGP), soluble Klotho, vitamin D, sclerostin, parathyroid hormone (PTH), fibroblast growth factor-23 (FGF-23), and osteoprotegerin levels. Based on our findings, it may be inappropriate to monotonously assume that male patients with CKD are at risk of VC compared to females, and we should consider more background in context before result interpretation.

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“…Calcificările parietale ale FAV la lotul de studiu au fost întâlnite la o mare parte dintre pacienți (70, adică 36,26%), într-o proporție similară cu cea raportată în diverse studii (13)(14)(15). În lotul nostru, calcificările au fost clasificate în: calcificări postanastomotice 45 (64,28%), calcificări extinse 23 (32,85%), calcificări stenozante 2 (2,85%).…”

Section: Calcificări Parietaleunclassified

Ultrasonografia de fistulă arterio-venoasă la pacientul hemodializat cronic – corelații clinico-imagistice

Știrbu¹,

Goldiș“²,

Țandrău³

et al. 2019

Ro Med J.

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Ultrasonografia de fistUlă arterio-venoasă la pacientUl hemodializat cronic -corelații clinico-imagisticeArterio-venous fistula ultrasound in chronic hemodialysis patients -clinical-imagistic correlations asist. Univ. drd. dr. oana Știrbu 1,2,3 , asist. Univ. drd. dr. mircea călin Ţandrău 1,2,3 , asist. Univ. dr. florica gădălean 2,4,5 , asist. Univ. dr. iulia grosu 2,4,5 , prof. dr. gheorghe ciobanu REzumatFistula arterio-venoasă (FAV) este accesul vascular de elecție pentru pacienții în program de hemodializă cronică. Complicațiile acesteia pot afecta grav viața pacientului, cresc morbiditatea și, consecutiv, costurile asistenței medicale. De rutină, fistula arterio-venoasă se evaluează clinic la ședința de dializă, însă numeroase complicații se pot diagnostica numai imagistic, inclusiv cele care periclitează buna funcționare a accesului și, implicit, a dializei. Ultrasonografia Doppler este noninvazivă, precisă, oferă detalii morfologice și funcționale și permite depistarea precoce a anomaliilor de fistulă arterio-venoasă, în plus este puțin costisitoare și nu presupune substanță de contrast și radiații ionizante. Obiectivul lucrării de față este de a stabili complicațiile accesului vascular la 193 de pacienți dializați din județul Arad, prin ecografie efectuată în centrul de dializă și de a determina implicațiile clinice ale acestor complicații. Cuvinte cheie: complicațiile fistulei arterio-venoase, ultrasonografie Doppler, implicații clinice aBStRaCtThe arterio-venous fistula is the elective vascular access for chronic hemodialysis patients. Its complications can severely affect the patient′s life, raise the morbidity and consequently the healthcare costs. Routinely, the arteriovenous fistula is evaluated clinically at the hemodialysis session, but numerous complications can only be diagnosed imastically, including those that endanger rhe well functioning of the access, and implicitely, of the dialysis. Doppler ultrasound is non-invasive, accurate, offers both morphological and functional details and allows the timely discovery of the anommalies of the arterio-venous fistula, moreover it is less costly and doesn′t require contrast media and ionizing radiations. The aim of the study is to establish the complications of the vascular access in 193 hemodialysis patients in Arad County, through Doppler ultrasound performed in the dialysis centre and to determine the clinical implications of these complications.

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Calcification in arteriovenous fistula blood vessels may predict arteriovenous fistula failure: a 5-year follow-up study

Abstract: Calcifications of AVF-blood vessels are found frequently among dialysis patients and may jeopardize the survival of native AVF. We suggested the local X-ray as simple and valid method for detection of patients that are at risk for AVFs failure which should be monitored more closely.

Cited by 11 publications

References 35 publications

Predictors associated with early and late restenosis of arteriovenous fistulas and grafts after percutaneous transluminal angiography

Predictors associated with early and late restenosis of arteriovenous fistulas and grafts after percutaneous transluminal angiography

Gender-Related Differences in Chronic Kidney Disease-Associated Vascular Calcification Risk and Potential Risk Mediators: A Scoping Review

Ultrasonografia de fistulă arterio-venoasă la pacientul hemodializat cronic – corelații clinico-imagistice

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