[an error occurred while processing this directive]

Association between abdominal aortic calcification and immaturation of autogenousarteriovenous fistula in patients with end-stage renal disease

  • LI Ting ,
  • WANG Xiu-Feng ,
  • ZHAO Yu-Jie ,
  • GUAN Lin-Meng ,
  • WANG Hui ,
  • SHAO Xiao-Lin ,
  • YANG Jun
Expand
  • Blood Purification Center of Kidney Disease Hospital, and 2Department of Hematology, The First Affiliated Hospital of Xinxiang Medical University, Weihui 453100, China

Received date: 2023-04-14

  Revised date: 2023-07-05

  Online published: 2023-09-12

Abstract

Objective  To explore the relationship between abdominal aortic calcification (AAC) and poor maturation of autologous arteriovenous fistula (AVF), and the influencing factors for poor maturation of AVF.  Methods  Patients with chronic kidney disease (CKD) at stage 5 and undergoing AVF construction for the first time at the First Affiliated Hospital of Xinxiang Medical university from October 2021 to October 2022 were enrolled in this study. Their general clinical data, hematological findings, AAC score, and preoperative and postoperative ultrasound examination results were collected. Patients were then divided into immature group and mature group according to physical examination, clinical use, and color Doppler ultrasound results after AVF surgery. Multivariate logistic regression was used to analyze the influencing factors for poor maturation of AVF.  Results  A total of 160 patients were included, with the age of 49.78±14.17 years old and 67.5% of males. There were statistically significant differences in age (t=4.078, P<0.001), diabetes history (χ 2=4.050, P=0.044), AAC score (t=7.056, P<0.001) and iPTH (t=2.151, P=0.035) between the two groups. Univariate logistic regression showed that age (OR=1.102, 95% CI 1.042~1.166, P=0.001), diabetes history (OR=2.807, 95% CI 1.010~7.803, P=0.048), AAC score (OR=1.559, 95% CI 1.269~1.915, P<0.001) and iPTH (OR=1.002, 95% CI 1.000~1.005, P=0.040) were associated with poor maturation of AVF. Multivariate logistic regression showed that age (OR=1.073, 95% CI 1.007~1.142, P=0.030) and AAC score (OR=1.478, 95% CI 1.197~1.825, P<0.001) were the independent influencing factors for poor maturation of AVF in CKD patients at stage 5.  Conclusions  Our study demonstrates that age and AAC score were the independent influencing factors for poor maturation of AVF. Therefore, age and AAC score should be considered in the evaluation of AVF maturation after operation.

Cite this article

LI Ting , WANG Xiu-Feng , ZHAO Yu-Jie , GUAN Lin-Meng , WANG Hui , SHAO Xiao-Lin , YANG Jun . Association between abdominal aortic calcification and immaturation of autogenousarteriovenous fistula in patients with end-stage renal disease[J]. Chinese Journal of Blood Purification, 2023 , 22(09) : 706 -709 . DOI: 10.3969/j.issn.1671-4091.2023.09.016

References

[1]Lok CE, Huber TS, Lee T, et al. KDOQI clinical practice guideline for vascular access: 2019 update[J]. Am J Kidney Dis, 2020, 75(4 Suppl 2): S1?S164.
[2][2]中国医院协会血液净化中心分会血管通路工作组.中国血液透析用血管通路专家共识(第2版)[J].中国血液净化,2019,18 (6):365—381.
[3]Duque JC, Tabbara M, Martinez L, et al. Dialysis Arteriovenous Fistula Failure and Angioplasty: Intimal?Hyperplasia and Other Causes of Access Failure. Am J Kidney Dis. 2017, 69(1):147-151.
[4]Honkanen E, Kauppila L, Wikstr?m B, et al. CORD study group. Abdominal aortic calcification in dialysis patients: results of the CORD study. Nephrol Dial Transplant. 2008, 23(12):4009-15.
[5]Allon M, Robbin ML, Umphrey HR, et al. Preoperative arterial microcalcification and clinical outcomes of arteriovenous fistulas for hemodialysis[J]. Am J Kidney Dis, 2015, 66(1): 84 ? 90.
[6]Cheung AK, Imrey PB, Alpers CE, et al. Intimal Hyperplasia, Stenosis, and Arteriovenous Fistula Maturation Failure in the Hemodialysis Fistula Maturation Study. J Am Soc Nephrol.2017;28(10):3005-3013.
[7]Jeong S, Kwon H, Chang JW, Kim MJ, Ganbold K, Han Y, Kwon TW, Cho YP. Comparison of outcomes between type 2 diabetic and non-diabetic incident hemodialysis patients with functioning arteriovenous fistulas. Medicine (Baltimore). 2019, 98(48):e18216.
[8] Li HL, Chan YC, Cui D, et al. Predictors of primary functional maturation of autogenous radiocephalic arteriovenous fistula in a cohort of Asian patients[J]. Ann Vasc Surg, 2020, 66: 326 ? 333.
[9] Shanahan CM, Crouthamel MH, Kapustin A, et al. Arterial calcification in chronic kidney disease: key roles for calcium and phosphate[J]. Circ Res, 2011, 109(6): 697 ? 711.
[10]Kra?niak A, Drozdz M, Pasowicz M, et al. Factors involved in vascular calcification and atherosclerosis in maintenance haemodialysis patients[J]. Nephrol Dial Transplant, 2007, 22(2): 515?521.
[11]Kubiak RW, Zelnick LR, Hoofnagle AN, et al. Hemodialysis Fistula Maturation Study Group. Mineral Metabolism Disturbances and Arteriovenous Fistula Maturation. Eur J Vasc Endovasc Surg. 2019 May;57(5):719-728.
[12]Woodside KJ, Bell S, Mukhopadhyay P, et al. Arteriovenous fistula maturation in prevalent hemodialysis patients in the United States: a national study[J]. Am J Kidney Dis, 2018, 71 (6): 793?801.
Outlines

/

[an error occurred while processing this directive]