Impact of Intraoperative and 24h Blood Pressure Levels and Presence of Arteriosclerosis on Arteriovenous Fistula

Abstract

Introduction: Creation and subsequent patency of arteriovenous fistula (AVF) is crucial for hemodialysis patients. Early thrombosis is one of the main reasons of fistula occlusion. This study aimed to explore the effect of blood pressure and the presence of visible arteriosclerosis in the artery used for anastomosis on the patency of AVF. Methods: This retrospective study AVF was created in 231 consecutive patients. We used the Brecio-Cimino technique to create AVF in 50% of patients. Perioperative systolic (SBP) and diastolic (DBP) blood pressures were recorded just before declampage and during the following 24-h period for each 6-h intervals. Age, gender, presence of macroscopic arteriosclerosis in the artery used for an astomosis, and the etiologic factors of chronic renal failure parameters were all equally recorded. Results: The overall early fistula survival rate was 83%. No statistically significant immediate fistula dysfunction in terms of blood pressure differences was found. The multivariate analysis of the factors related to the AV fistula in the first 24 h patency revealed that only upper arm fistula was more likely effective (OR=1.192, p=0.003). Discussion and Conclusion: The effect of age, gender, presence of arteriosclerosis, and the history of existence of central venous catheter on early AVF patency was not observed. The rate of fistula patency was higher in the upper arm compared to fistulas in the lower arm. No significant difference concerning AVF patency was observed between patients with arterial blood pressure higher or lower than 120 mmHg.