Less primary fistula failure in hypertensive patients

Abstract

End stage renal disease (ESRD) patients suffer from advanced renal diseases and actually nonfunctioning kidneys, and need kidney transplantation or dialysis. Hemodialysis (HD) is the most used method and requires a vascular access (VA). Arteriovenous fistula (AVF) is the first choice of VA over the world for having least morbidity and mortality. Despite the wide-spread use of AVFs, the rate of AVF failures are notable. Detecting the factors that cause AVF failure can reduce repeating VA surgeries and hospitalization of ESRD patients. Present research studies 480 Iranian HD patients who underwent AVF surgery from 2010 to 2017 and aged 18-90 years old, using data mining techniques. (i) The AVF failure rate was equal to 8.96%, such that AVF failure has occurred in 3.54% and 5.52% of HD patient with and without hypertension, respectively. (ii) The rate of non-failure AVF in hypertensive patients is 61.46%, whereas the same rate for patients with negative history of hypertension reaches to 29.58%. (iii) Hypertension has a significant inverse association with AVF failure (Spearman's ρ = -0.160, P-value ≤ 0.005). (iv) The decision tree (with accuracy rate = 92.24%) shows less AVF failure in hypertsensive patients (5.53%) comparing with non-hypertensive patients (15.09%). (v) The AVFs with greater failure rates and non-hypertensive HD patients were clustered together. "Significantly lower risk of AVF failure was associated with presence of a positive history of hypertension; in other words, positive history of hypertension has an adverse effect on AVF failure and Hypertensive HD patients have more maturated AVF."

Early Failure of Arteriovenous Fistula (AVF): The Effect of Diabetes and Hypertension in a Cross-Sectional Study

“…Studies have a different definition of primary failure but overall, early failure is defined as AVF never maturing to support dialysis or that fails within three months of use and diagnosed as thrombosis and immediate failure of fistula (3)(4)(5). The overall risk of early failure was 23% but increased to 37% in the elderly (5).…”

A Novel Approach to Decision-Making on Diagnosing Oncological Diseases Using Machine Learning Classifiers Based on Datasets Combining Known and/or New Generated Features of a Different Nature

“…Currently, data mining and machine learning technologies are actively used to solve various problems of medical diagnostics, including solving the problems of diagnosing ODs [10][11][12][13][14][15][16][17][18][19]. In this case, classifiers are developed based on appropriate datasets.…”

A central arteriovenous fistula reduces systemic hypertension in a mouse model

“…On the other hand, several studies have reported an association of hypertension with higher rates of successful AVF maturation. 29 , 30 , 31 , 32 In these cases, increased SMC number and collagen deposition could increase wall strength and contribute to improved AVF maturation. These seemingly paradoxical influences of hypertension on AVF maturation and long-term patency, and whether anti-hypertensive therapy has an effect on AVF maturation, require further investigation.…”