Objective To investigate the maturation rate of autologous arteriovenous fistula (AVF) in peritoneal dialysis (PD) patients, and to explore the influencing factors for AVF failure in PD patients. Methods Patients on PD undergoing AVF surgery for the first time in the hospital between January 1,2018 and June 30, 2023 were enrolled in this study. According to whether the AVF maturation with assistance, the patients were divided into the non-assisted AVF maturation group and the non-assisted AVF failure group. Baseline data were compared between the two groups. Multivariate logistic regression was used to analyze the influencing factors for AVF failure. Results A total of 116 PD patients were enrolled in this study. The non-assisted AVF maturation rate was 76% and the assisted AVF maturation rate was 93%. In the non-assisted AVF failure group, female proportion was higher (χ²=10.830, P=0.001), mean arterial pressure was lower (t=3.106, P=0.002), ratio of diabetes as the primary disease was higher (χ²=4.087, P=0.043), and preoperative hemoglobin level was higher (t=-2.376, P=0.019). Multivariate logistic regression showed that female (OR=4.813, 95% CI: 1.736～13.339, P=0.003) and mean arterial pressure (OR=0.960, 95% CI: 0.927～0.995, P=0.024) were the independent risk factors for AVF failure in PD patients. Conclusions The maturation rate of the first AVF in PD patients is similar to that in general population. Females and lower preoperative mean arterial pressure are associated with poor AVF maturation in PD patients.
JIANG Zuan-Hong
,
ZHANG Hong
,
ZHOU Ling-Ling
,
SHAO Song-Hua
,
WANG Ying
,
XU Li-Yun
. Study on the influencing factors of autogenous arteriovenous fistula failure in peritoneal dialysis patients[J]. Chinese Journal of Blood Purification, 2024
, 23(10)
: 779
-783
.
DOI: 10.3969/j.issn.1671-4091.2024.10.011
[1]闵永龙, 刘红, 李红波, 等.单中心 例腹膜透析患者的转归分析[J].中国血液净化, 2018, 17(03):170-176
[2]王一范, 占小江, 陈岩冰, 等.腹膜透析患者退出原因分析[J].中华肾脏病杂志, 2019, 35(4):275-280
[3]Ravani P, Palmer SC, Oliver MJ, et al.Associations between hemodialysis access type and clinical outcomes: a systematic review[J].J Am Soc Nephrol, 2013, 24(3):465-473
[4]Sabiu G, Gallieni M.Pathophysiology of Arteriovenous Fistula Maturation and Nonmaturation[J].Clin J Am Soc Nephrol, 2023, 18(1):8-10
[5]赵彬, 王慧, 王玉柱, 等.自体动静脉内瘘成熟的预测因素及辅助成熟干预时机的初步探讨[J].中华肾脏病杂志, 2023, 39(4):263-271
[6]甘文渊, 肖伟, 徐力, 等.自体动静脉内瘘成熟的影响因素[J].中华肾脏病杂志, 2021, 37(8):655-661
[7]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
[8]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 版[J].中国血液净化, 2019, 18(06):365-381
[9]北京围手术期医学研究会肾脏病与血液净化分会专家共识工作组.新建自体动静脉内瘘围手术期管理专家共识[J].中国血液净化, 2023, 22(12):881-890
[10]Pisoni RL, Zepel L, Zhao J, et al.International Comparisons of Native Arteriovenous Fistula Patency and Time to Becoming Catheter-Free: Findings From the Dialysis Outcomes and Practice Patterns Study (DOPPS)[J].Am J Kidney Dis, 2021, 77(2):245-254
[11]Huber TS, Berceli SA, Scali ST, et al.Arteriovenous Fistula Maturation,Functional Patency,and Intervention Rates[J].JAMA Surg, 2021, 156(12):1111-1118
[12]Wan ZM, Hu B, Lai QQ, et al.Radial artery diameterand and age related functional maturation of the radio-cephalic arteriovenous fistula[J].BMC Nephrol, 2020, 21(1):234-
[13]Borghese O, Pisani A, Lajmi M, et al.Tailoring Hemodialysis Vascular Access in Diabetic Patients[J]. [J].Ann Vasc Surg, 2021, 73:155-164
[14]Qian JZ, McAdams-DeMarco M, Ng DK, et al.Arteriovenous Fistula Placement,Maturation,and Patency Loss in Older Patients Initiating Hemodialysis[J].Am J Kidney Dis, 2020, 76(4):480-489
[15]Drouven JW, de Bruin C, van Roon AM, et al.Vascular access creation in octogenarians: The effect of age on outcomes[J].J Vasc Surg, 2020, 72(1):171-179
[16]Hoffstaetter T, Silpe J, Delijani D, et al.Sex Disparities in Arteriovenous Fistula Maturation Outcomes[J]. [J].Ann Vasc Surg, 2023, 95:197-202
[17]王春丽, 杨涛, 张丽红, 等.糖尿病对动静脉内瘘成熟影响的临床研究[J].中国血液净化, 2016, 15(10):573-575
[18]Pandey S, Kumar M, Agrawal M, et al.The effects of preoperative blood pressure on early failure rate of distal arteriovenous fistulas for hemodialysis access[J].Hemodial Int, 2019, 23(3):314-318
[19]He Y, Shiu YT, Imrey PB, et al.Association of Shear Stress with Subsequent Lumen Remodeling in Hemodialysis Arteriovenous Fistulas[J].Clin J Am Soc Nephrol, 2023, 18(1):72-83
[20]Farrington CA, Robbin ML, Lee T, et al.Postoperative Ultrasound,Unassisted Maturation,and Subsequent Primary Patency of Arteriovenous Fistulas[J].Clin J Am Soc Nephrol, 2018, 13(9):1364-1372
[21]Robbin ML, Greene T, Allon M, et al.Prediction of Arteriovenous Fistula Clinical Maturation from Postoperative Ultrasound Measurements: Findings from the Hemodialysis Fistula Maturation Study[J].J Am Soc Nephrol, 2018, 29(11):2735-2744
[22]Lopes JRA, Marques ALB, Correa JA.Randomised clinical study of the impact of routine preoperative Doppler ultrasound for the outcome of autologous arteriovenous fistulas for haemodialysis[J].J Vasc Access, 2021, 22(1):107-114
