Factors influencing dialysis arteriovenous graft survival

Valeriánová, Anna; Kudlicka, Jaroslav; Chytilova, Eva; Grauova, Barbora; Krupickova, Zdislava; Malík, Jan

doi:10.5301/jva.5000632

Cited by 11 publications

(8 citation statements)

References 29 publications

(27 reference statements)

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“…revealed that compared to nonsmoking patients, smoking patients had lower AVG thrombosis rates. 38,39 Therefore, our result indicating a protective effect of smoking on AVG patency is not unique.…”

Section: Discussionmentioning

confidence: 65%

Effect of carvedilol on arteriovenous graft primary patency

et al. 2020

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Background The major mechanisms of arteriovenous graft (AVG) failure due to intimal hyperplasia (IH) are smooth muscle cell proliferation and inflammation. Therefore, carvedilol may improve AVG primary patency because of its anti-proliferative and anti-inflammatory activities. Methods The data of end-stage renal disease patients receiving regular hemodialysis were collected from the National Health Insurance Research database. The end point was the first percutaneous transluminal angioplasty (PTA) for AVG failure or death during a follow-up period of two years or the end of 2013. The analysis was calculated with Cox proportional hazard model. Results There were 3028 patients treated with carvedilol and 13,704 patients not treated with carvedilol. According to a univariate analysis, the carvedilol group was younger, received more anti-hypertensive medications and platelet aggregation inhibitors, and had higher rates of diabetes mellitus and hyperlipidemia but had lower rates of hypotension and smoking. According to a multivariate analysis, after controlling for covariates, the use of carvedilol for more than 84 days reduced the probability of a first PTA for AVG failure by 9% compared with no use of carvedilol ( p = 0.021), but the use of carvedilol for 1 to 84 days did not. Conclusion The results of this study indicate that the use of carvedilol for more than 84 days improves the primary patency of AVGs, but the use of carvedilol for less than 84 days does not.

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Section: Discussionmentioning

confidence: 65%

Effect of carvedilol on arteriovenous graft primary patency

et al. 2020

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“…Patients may develop steal in case of ipsilateral AVF and left internal mammary coronary artery bypass grafting with worsening of angina pectoris (10). Interestingly, the presence of coronary artery disease is associated with shorter arteriovenous graft lifespan (11).…”

Section: Arterial Diseasementioning

confidence: 99%

Heart disease in chronic kidney disease – review of the mechanisms and the role of dialysis access

Malík

2018

J Vasc Access

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REVIEW misinterpreted as pure overhydration and vice versa. Various attempts to emphasize the role of heart disease in chronic kidney disease (CKD) patients have been published-from the well-known cardiorenal syndrome classification by Ronco et al (2) to the recent conclusions of the Acute Dialysis Quality Initiative XI Workgroup (3), which proposed a new classification of heart failure in ESRD patients. The latter workgroup specifically excludes patients with simple water overload and a normal heart, and focuses on those having specific echocardiographical changes. These include 3 elements: (i) ECHO evidence of structural or functional heart abnormalities; (ii) shortness of breath occurring in the absence of pulmonary disease; and (iii) the response of congestive symptoms to ultrafiltration (3). The same group (4) selected the following 8 echocardiographic criteria of structural heart disease; it is present if at least 1 criterion is detected (see Tab. I). Although this attempt to standardize the definition of structural heart disease in ESRD patients is respectable, some important issues were missed, such as pulmonary hypertension, lack of any cardiac calcification score, and the presence of significant coronary artery disease. Moreover, their cutoff values for various pathological findings differ from the European and American guidelines for echocardiography (Tab. I). The particular pathological changes are noted below. Arterial disease Characteristics Patients suffering from ESRD are also affected by accelerated atherosclerosis (disease of the intimal arterial wall layer) and from medial calcinosis. Etiopathogenesis Atherogenesis is accelerated due to the higher occurrence of traditional risk factors: diabetes mellitus, arterial hypertension, changes of serum lipids, plus the uremic millieu interieur Heart disease in chronic kidney diseasereview of the mechanisms and the role of dialysis access

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“…1,6) Many factors that may affect the patency of AVG have been proposed, such as medication (clopidogrel, aspirin, and dipyridamole), coronary disease, serum cholesterol level, location, and configuration. 7,8) In our study, no improvement of patency was shown among patients on antiplatelet or anticoagulant therapy ( Table 1 ). In many studies, the correlation between the location of AVG and the patency has been evaluated, and these results may imply that the more proximal the anastomosis the larger the vessel and better patency.…”

Section: Discussionmentioning

confidence: 47%

The Effect of Artery and Vein Size on Forearm Hemodialysis Arteriovenous Graft Patency

Kritayakirana

Narueponjirakul

Uthaipaisanwong

et al. 2019

Annals of Vascular Diseases

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Objective: Arteriovenous grafts (AVGs) are considered to be an alternative procedure when autogenous fistulas are not feasible. This study was conducted to establish a correlation between the inflow artery and outflow vein size and patency of AVGs.Materials and Methods: This was a retrospective descriptive study. Data was collected from patients who had forearm AVG performed at a university hospital from January 1, 2012, to December 31, 2016. Spearman’s rho correlation test was used to identify the correlation between the artery and vein size and patency of AVG.Results: A total of 34 patients were enrolled in this study. Forearm loop configuration was performed in 33 patients (97%), and straight configuration was performed in one patient (3%). The median size of the brachial artery was 3 mm (interquartile range [IQR]: 2, 4) and that of the vein was 3 mm (IQR: 2, 5). The overall primary patency was 74% at six months, 59% at one year, and 32% at two years. The analysis showed that the primary patency increased with the artery size, but there was a reverse correlation between vein sizes.Conclusion: Small inflow arteries may reduce the primary patency, but small veins do not result in a poor primary patency. Our method can be applied to patients with small veins, where it is still possible to perform forearm AVGs.

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Factors influencing dialysis arteriovenous graft survival

Abstract: Coronary artery disease negatively influences the cumulative patency of vascular access. Higher serum cholesterol levels are associated with lower AVG failure risk over a 1000-day period, which probably corresponds to the worse disease status of the patients with lower cholesterol values.

Cited by 11 publications

References 29 publications

Effect of carvedilol on arteriovenous graft primary patency

Effect of carvedilol on arteriovenous graft primary patency

Heart disease in chronic kidney disease – review of the mechanisms and the role of dialysis access

The Effect of Artery and Vein Size on Forearm Hemodialysis Arteriovenous Graft Patency

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