Stolic Radojica V, Trajkovic Goran Z, Kostic Mirjana M, Mihailovic Branko, Jovanovic Aleksandar N, Lazic Bratislav D, Matijasević Ivana R, Jaksić Maša D, Mirkovic Zlatica M, Smilic Tanja N, Mitic Javorka S
Department of Internal Medicine, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia.
Faculty of Medicine, Institute of Medical Statistics and Informatics, University of Belgrade, Belgrade, Serbia.
Hemodial Int. 2018 Jul;22(3):328-334. doi: 10.1111/hdi.12615. Epub 2017 Nov 12.
Arteriovenous fistulas (AVFs) are the preferred form vascular access for hemodialysis (HD), as they have a low rate of complications and durable function. The aim of our investigation was to analyze the factors that might influence the function of AVFs.
Data were taken from the computerized patient record system in the Clinic of Urology and Nephrology, Clinical Center, Kragujevac, Serbia, for a 2-year period. We analyzed patients who had requested re-creation of AVFs as a secondary procedure. During this period 112 patients, 73 (65%) men and 39 (35%) women, had AVF thromboses. All relevant clinical and laboratory parameters that could affect the function and survival of AVF were evaluated.
In univariate logistic regression analysis, statistically significant predictors influencing the duration of the fistula were magnesium (P < 0.001), triglycerides (P = 0.041), smoking (P = 0.001), antiplatelet therapy (P < 0.001), and type of HD (bicarbonate vs. hemodiafiltration) (P < 0.001). In the multiple logistic regression model, high concentrations of magnesium (B = 7.434; P < 0.001) and antiplatelet therapy (B - 1.042; P = 0.04) were significantly associated with the length of AVF function.
After successful establishment of an AVF, there is a compelling need to maintain fistula patency. Factors that affect functioning of the AVFs are presently under intense scrutiny. According to our results, some clinical factors may determine long term fistula duration, such as concentration of the magnesium and antiplatelet therapy.
动静脉内瘘（AVF）是血液透析（HD）血管通路的首选形式，因为其并发症发生率低且功能持久。我们研究的目的是分析可能影响动静脉内瘘功能的因素。
数据取自塞尔维亚克拉古耶瓦茨临床中心泌尿外科和肾脏病科的计算机化患者记录系统，为期2年。我们分析了作为二次手术要求重新建立动静脉内瘘的患者。在此期间，112例患者，73例（65%）男性和39例（35%）女性发生了动静脉内瘘血栓形成。评估了所有可能影响动静脉内瘘功能和存活的相关临床和实验室参数。
在单因素逻辑回归分析中，影响内瘘持续时间的具有统计学意义的预测因素为镁（P < 0.001）、甘油三酯（P = 0.041）、吸烟（P = 0.001）、抗血小板治疗（P < 0.001）和血液透析类型（碳酸氢盐透析与血液透析滤过）（P < 0.001）。在多因素逻辑回归模型中，高浓度镁（B = 7.434；P < 0.001）和抗血小板治疗（B = -1.042；P = 0.04）与动静脉内瘘功能的持续时间显著相关。
成功建立动静脉内瘘后，迫切需要维持内瘘通畅。目前正在对影响动静脉内瘘功能的因素进行深入研究。根据我们的结果，一些临床因素可能决定内瘘的长期持续时间，如镁的浓度和抗血小板治疗。
