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动静脉内瘘的成熟:关键因素分析

Maturation of arteriovenous fistula: Analysis of key factors.

作者信息

Siddiqui Muhammad A, Ashraff Suhel, Carline Thomas

机构信息

Professional Faculties, University of Calgary, Calgary, Canada.

Diabetes and Endocrinology, James Cook University Hospital, Middlesbrough, United Kingdom.

出版信息

Kidney Res Clin Pract. 2017 Dec;36(4):318-328. doi: 10.23876/j.krcp.2017.36.4.318. Epub 2017 Dec 31.

Abstract

The growing proportion of individuals suffering from chronic kidney disease has considerable repercussions for both kidney specialists and primary care. Progressive and permanent renal failure is most frequently treated with hemodialysis. The efficiency of hemodialysis treatment relies on the functional status of vascular access. Determining the type of vascular access has prime significance for maximizing successful maturation of a fistula and avoiding surgical revision. Despite the frequency of arteriovenous fistula procedures, there are no consistent criteria applied before creation of arteriovenous fistulae. Increased prevalence and use of arteriovenous fistulae would result if there were reliable criteria to assess which arteriovenous fistulae are more likely to reach maturity without additional procedures. Published studies assessing the predictive markers of fistula maturation vary to a great extent with regard to definitions, design, study size, patient sample, and clinical factors. As a result, surgeons and specialists must decide which possible risk factors are most likely to occur, as well as which parameters to employ when evaluating the success rate of fistula development in patients awaiting the creation of permanent access. The purpose of this literature review is to discuss the role of patient factors and blood markers in the development of arteriovenous fistulae.

摘要

慢性肾病患者比例的不断增加,对肾脏专科医生和初级保健都产生了重大影响。进行性和永久性肾衰竭最常采用血液透析治疗。血液透析治疗的效果取决于血管通路的功能状态。确定血管通路的类型对于最大限度地提高内瘘成功成熟率和避免手术修正至关重要。尽管动静脉内瘘手术很常见,但在创建动静脉内瘘之前并没有统一适用的标准。如果有可靠的标准来评估哪些动静脉内瘘更有可能在无需额外手术的情况下成熟,那么动静脉内瘘的患病率和使用率将会增加。已发表的评估内瘘成熟预测指标的研究在定义、设计、研究规模、患者样本和临床因素方面差异很大。因此,外科医生和专科医生必须确定哪些可能的风险因素最有可能出现,以及在评估等待创建永久性通路的患者内瘘发育成功率时应采用哪些参数。这篇文献综述的目的是讨论患者因素和血液标志物在动静脉内瘘形成中的作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d5c6/5743041/4cca4f48886e/krcp-36-318f1.jpg

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