Factors affecting the patency of arteriovenous fistulas for hemodialysis: Single center experience

Stolić, Radojica; Trajković, Goran; Kostić, Mirjana; Mihailović, B.; Jovanovic, Aleksandar; B, Lazić; Matijašević, Ivana R.; Jakšić, Maša D.; Mirkovic, Zlatica M.; Smilić, Tanja; Mitic, Javorka S.

doi:10.1111/hdi.12615

Cited by 17 publications

(11 citation statements)

References 29 publications

(54 reference statements)

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“…[65][66][67][68] Interestingly, hypomagnesaemia promotes inflammation, oxidative stress, endothelial dysfunction and atherogenesis, and studies have demonstrated its negative impact in AVF outcomes. 69,70 In addition, thrombophilia and coagulation abnormalities have also associated with AVF failure. 71,72 In view of the increasing age and prevalence of co-morbidities of CKD patients, it is imperative to carry out further research into the contributing factors to AVF maturation and dysfunction.…”

Section: Pre-operative Artery and Vein Characteristicsmentioning

confidence: 99%

Factors affecting arteriovenous fistula dysfunction: A narrative review

Gameiro

Ibeas

2019

J Vasc Access

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Vascular access dysfunction is one of the most important causes of morbidity and mortality in haemodialysis patients, contributing to up to one third of hospitalisations and accounting for a significant amount of the health care costs of these patients. In the past decades, significant scientific advances in understanding mechanisms of arteriovenous fistula maturation and failure have contributed to an increase in the amount of research into techniques for creation and strategies for arteriovenous fistula dysfunction prevention and treatment, in order to improve patient care and outcomes. The aim of this review is to describe the pathogenesis of vascular access failure and provide a comprehensive analysis of the associated risk factors and causes of vascular access failure, in order to interpret possible future therapeutic approaches. Arteriovenous fistula failure is a multifactorial process resulting from the combination of upstream and downstream events with consequent venous neo-intimal hyperplasia and/or inadequate outward remodelling. Inflammation appears to be central in the biology of arteriovenous fistula dysfunction but important triggers still need to be revealed. Given the significant association of arteriovenous fistula failure and patient’s prognosis, it is therefore imperative to further research in this area in order to improve prevention, surveillance and treatment, and ultimately patient care and outcomes.

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Section: Pre-operative Artery and Vein Characteristicsmentioning

confidence: 99%

Factors affecting arteriovenous fistula dysfunction: A narrative review

Gameiro

Ibeas

2019

J Vasc Access

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“…Several factors such as age, the presence of DM, higher body mass index, smoking status, history of cytomegalovirus infection, higher total cholesterol level, lower protein intake, the presence of PAD, and taking antiplatelet agents are considered risk factors for vascular access dysfunction [22,23,24,25,26]. Despite the heterogeneity of the factors related with vascular access survival, recent studies have revealed several major common pathways such as inflammation, oxidative stress, uremia, hypoxia, increased thrombogenicity, and shear stress that are responsible for progressive neointimal hyperplasia and propagating thrombosis [14,15].…”

Section: Discussionmentioning

confidence: 99%

The Effect of Aspirin on Preventing Vascular Access Dysfunction in Incident Hemodialysis Patients: A Prospective Cohort Study in Korean Clinical Research Centers for End-Stage Renal Disease (CRC for ESRD)

Kim

et al. 2019

JCM

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Background: Aspirin is often prescribed empirically to improve the patency of hemodialysis (HD) vascular access. Therefore, this study aimed to investigate the impact of aspirin on the survival of vascular access in incident HD patients with arteriovenous fistula (AVF) or arteriovenous graft (AVG). Methods: A prospective cohort of 881 incident HD patients was enrolled between 2009 and 2014. The primary outcome was defined as the first AVF/AVG intervention or salvage procedure, including percutaneous transluminal angioplasty or surgery for vascular access failure. Cox analyses were performed to determine the association between aspirin usage and the occurrence of the primary outcome. Results: The mean age of the patient group was 57.9 ± 13.4, and 63.8% of the patients were male. Aspirin was prescribed in 241 (27.4%) patients, and the median follow-up duration was 30 months. During follow-up, 180 (20.4%) patients experienced the primary outcome event. Univariate analysis showed that age, gender, presence of diabetes mellitus (DM), preexisting peripheral arterial disease, and the type of vascular access used (AVG versus AVF) were significantly associated with the development of the primary outcome. However, aspirin usage from the baseline was not significantly associated with primary outcome events (hazard ratio (HR): 1.16; 95% confidence interval (CI): 0.84–1.60; p = 0.378). Multivariate analysis showed that gender, the presence of DM, and the type of vascular access were still significantly associated with the occurrence of the primary outcome. Moreover, we did not observe the protective effect of taking aspirin on primary vascular access failure, even in subgroup analyses stratified according to gender, the presence of DM, and the type of vascular access. Conclusion: Physicians should carefully consider when they prescribe aspirin for the prevention of primary vascular access failure in Korean incident HD patients. In addition, larger prospective interventional studies are needed to elucidate the effect of aspirin on vascular access failure.

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“…3 Native arteriovenous fistula (AVF) is the most intensively preferred vascular access method owing to its longevity and since it ensures receiving easy and comfortable hemodialysis. 2,4 Native AVF has also been suggested as the first preferred choice by current guidelines for vascular access in patients undergoing hemodialysis treatment. 1,5 However, AVF occlusion is one of the most frequent causes of hospitalization in patients receiving hemodialysis.…”

Section: Introductionmentioning

confidence: 99%

Relationship between hemodialysis patients’ educational level and arteriovenous fistula patency

Yolgösteren

2020

Vascular

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Objectives Vascular access is a lifeline for the patients who are in need of long-term hemodialysis. Native arteriovenous fistula is the most intensively preferred vascular access method owing to its longevity and convenience of use. Therefore, in this study, we aimed to determine whether there might be a relationship between hemodialysis patients’ educational levels and arteriovenous fistula patency. Methods A total of 349 patients who were attending in a chronic hemodialysis program between June 2018 and September 2018 at Bursa Uludağ University, Faculty of Medicine Dialysis Unit and in a private dialysis center in İstanbul were included in this study. The patients were grouped into two: those who have had arteriovenous fistula primary failure at least once and those who have never had arteriovenous fistula primary failure. Educational levels of the patients were classified according to Turkish National Education system (illiterate, primary school graduate, secondary school graduate, high school graduate, and university graduate). Mann–Whitney U and Chi-square tests were performed for statistical analyses. Risk factors were determined by applying backward binary logistic regression analysis. Results A total of 349 patients, 161 (46.1%) females and 188 (53.9%) males, were examined retrospectively. The median age of the patients was 64 years (range: 18–90 years). Educational level comparison revealed statistically significant difference in terms of fistula patency ( p = 0.016). In particular, fistula patency was significantly lower in illiterate, primary, secondary, and high school graduates in comparison with university graduates ( p = 0.001, p = 0.015, p = 0.003, and p = 0.018, respectively). When each group of educational level was analyzed separately in terms of fistula patency, it was observed that the higher the educational level was, the lower arteriovenous fistula primary failure rates were. Conclusions In this study, we observed a lower rate of fistula patency in patients with a low level of education. Hence, we are of the opinion that the trainings delivered on arteriovenous fistula care in dialysis centers are required to be shaped in accordance with educational levels of patients.

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Factors affecting the patency of arteriovenous fistulas for hemodialysis: Single center experience

Cited by 17 publications

References 29 publications

Factors affecting arteriovenous fistula dysfunction: A narrative review

Factors affecting arteriovenous fistula dysfunction: A narrative review

The Effect of Aspirin on Preventing Vascular Access Dysfunction in Incident Hemodialysis Patients: A Prospective Cohort Study in Korean Clinical Research Centers for End-Stage Renal Disease (CRC for ESRD)

Relationship between hemodialysis patients’ educational level and arteriovenous fistula patency

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