Khavanin Zadeh Morteza, Mohammadipour Saman, Omrani Zahra
MD, Assistant Professor of Surgery, Rasoul Akram Hospital, Iran University of Medical Sciences (IUMS), Tehran, Iran.
MD, General Surgeon, Rasoul Akram Hospital, Iran University of Medical Sciences (IUMS), Tehran, Iran.
Med J Islam Repub Iran. 2015 Jun 8;29:219. eCollection 2015.
Arteriovenous Fistula (AVF) is the ideal method of vascular access for patients on maintenance hemodialysis (HD). Therefore it is an important part of treatment in HD. There are several observations that indicate the role of inflammation in failure of AVF. The aim of this study was to evaluate the hematologic and inflammatory biomarkers in early AVF failure.
This case-control study included 110 ESRD patients, whom were undergone AVF creation, divided in two groups. About 700 radius-cephalic AVF were created during these two years. We found 55 cases with AVF failure. In this study, we compared those 55 failures with 55 functional AVF which were selected using randomized sampling from the rest of patients according to age, gender, and AVF location. Levels of serum C-reactive protein (CRP) were checked in both groups to evaluate the relation between AVF failure and CRP level before surgery.
The mean±SD age of the patients was 49.7±17.28 years. CRP was positive in 34 patients (61.8%) with unsuccessful fistula function, while only 4 (7.3%) of those with successful AVF had positive CRP and the rest had negative CRP. The difference between the two groups of patients was strongly significant (p<0.001). Statistically, there was not any significant difference between the average of age (p: 0.580) of patients in the control and experimental groups. However, the gender (p: 0.832) discrepancies was not meaningful between the groups.
AVF thrombosis is one of the main complications after AVF creation. Therefore, it is recommended to check CRP before AVF surgery to prevent possible failure of the fistula function.
动静脉内瘘(AVF)是维持性血液透析(HD)患者血管通路的理想方法。因此,它是HD治疗的重要组成部分。有多项观察表明炎症在AVF失败中起作用。本研究的目的是评估早期AVF失败中的血液学和炎症生物标志物。
本病例对照研究纳入了110例行AVF造瘘术的终末期肾病(ESRD)患者,分为两组。在这两年中创建了约700例桡动脉-头静脉内瘘。我们发现55例AVF失败病例。在本研究中,我们将这55例失败病例与55例功能正常的AVF进行比较,这些功能正常的AVF是根据年龄、性别和AVF位置从其余患者中随机抽样选取的。检查两组患者的血清C反应蛋白(CRP)水平,以评估手术前AVF失败与CRP水平之间的关系。
患者的平均年龄±标准差为49.7±17.28岁。瘘管功能未成功的34例患者(61.8%)CRP呈阳性,而AVF成功的患者中只有4例(7.3%)CRP呈阳性,其余患者CRP呈阴性。两组患者之间的差异非常显著(p<0.001)。统计学上,对照组和实验组患者的平均年龄(p:0.580)没有任何显著差异。然而,两组之间的性别差异(p:0.832)没有意义。
AVF血栓形成是AVF创建后的主要并发症之一。因此,建议在AVF手术前检查CRP,以预防瘘管功能可能出现的失败。