Predictive Parameters of Arteriovenous Fistula Functional Maturation in a Population of Patients with End-Stage Renal Disease

PLoS One

Sawsan Elsheikh¹  Liam Casserly²  Stewart R. Walsh³  Eamon G. Kavanagh⁴  Mary Clarke-Moloney⁴  Donagh A. Healy⁴  Khalid Bashar⁴  Paul E. Burke⁴  Adeel Zafar⁴ 

[1] Department of Acute Medicine, James Connolly Memorial Hospital, Dublin, Ireland;Department of Nephrology, University Hospital Limerick, Limerick, Ireland;Department of Surgery, National University of Ireland, Galway, Ireland;Department of Vascular Surgery, University Hospital Limerick, Limerick, Ireland

关键词: Fistulas;    Diabetes mellitus;    Calcium channels;    Medical dialysis;    Renal transplantation;    Chronic kidney disease;    Blood;    Catheters;   

DOI  :  10.1371/journal.pone.0119958

学科分类：医学（综合）

来源: Public Library of Science

【 摘 要 】

Introduction With increasing numbers of patients diagnosed with ESRD, arteriovenous fistula (AVF) maturation has become a major factor in improving both dialysis related outcomes and quality of life of those patients. Compared to other types of access it has been established that a functional AVF access is the least likely to be associated with thrombosis, infection, hospital admissions, secondary interventions to maintain patency and death. Aim Study of demographic factors implicated in the functional maturation of arteriovenous fistulas. Also, to explore any possible association between preoperative haematological investigations and functional maturation. Methods We performed a retrospective chart review of all patients with ESRD who were referred to the vascular service in the University Hospital of Limerick for creation of vascular access for HD. We included patients with primary AVFs; and excluded those who underwent secondary procedures. Results Overall AVF functional maturation rate in our study was 53.7% (52/97). Female gender showed significant association with nonmaturation (P = 0.004) and was the only predictor for non-maturation in a logistic regression model (P = 0.011). Patients who had history of renal transplant (P = 0.036), had relatively lower haemoglobin levels (P = 0.01) and were on calcium channel blockers (P = 0.001) showed better functional maturation rates. Conclusion Female gender was found to be associated with functional non-maturation, while a history kidney transplant, calcium channel-blocker agents and low haemoglobin levels were all associated with successful functional maturation. In view of the conflicting evidence in the literature, large prospective multi-centre registry-based studies with well-defined outcomes are needed.

【 授权许可】

CC BY