Gjorgjievski Nikola, Dzekova-Vidimliski Pavlina, Gerasimovska Vesna, Pavleska-Kuzmanovska Svetlana, Gjorgievska Julija, Dejanov Petar, Sikole Aleksandar, Ivanovski Ninoslav
University Hospital of Nephrology, Faculty of Medicine, Ss Cyril and Methodius University of Skopje, Skopje, Republic of Macedonia.
University Children Hospital, Skopje, Republic of Macedonia.
Open Access Maced J Med Sci. 2019 Jun 15;7(11):1782-1787. doi: 10.3889/oamjms.2019.541.
An Arteriovenous fistula (AVF) is a creation of the natural blood vessels. It is a "gate of life" for the patients on hemodialysis.
The study aimed to analyze the predictors for primary failure of AVF such as gender, age, number and location of AVF, and primary renal disease in patients with chronic kidney disease (CKD) stage 4/5.
The medical records of 178 created arteriovenous fistulae in patients with CKD stage 4/5, were retrospectively studied. Primary failure of AVF was defined as thrombosis or inability for cannulation of AVF within 3 months. Adequate maturation of AVF was defined as successful cannulation of AVF treatment and blood flow of > 600 ml/min.
The mean age of the patients was 59.75 ± 14.65 years, and 65.16% (116/178) were men. Adequate maturation of AVF was achieved in 83.71% (149/178). Primary failure of AVF occurred in 16.29% (29/178) of the created fistulae, while 10.11% (18/178) had early thrombosis. The distal arteriovenous fistulae were significantly more frequently created in male patients (51 vs 18; p = 0.015). The female patients were significantly older than the male patients (63.27 vs 57.86 years; p = 0.018).
Male gender was associated with better maturation of AVF. The age, number and location of AVF, and primary renal disease in patients with CKD stage 4/5 were not associated with primary failure of AVF.
动静脉内瘘（AVF）是通过天然血管构建而成。它是血液透析患者的“生命之门”。
本研究旨在分析慢性肾脏病（CKD）4/5期患者动静脉内瘘初次失败的预测因素，如性别、年龄、动静脉内瘘的数量和位置以及原发性肾脏疾病。
回顾性研究了178例CKD 4/5期患者构建的动静脉内瘘的病历。动静脉内瘘初次失败定义为在3个月内动静脉内瘘发生血栓形成或无法进行穿刺。动静脉内瘘充分成熟定义为动静脉内瘘穿刺治疗成功且血流量>600 ml/min。
患者的平均年龄为59.75±14.65岁，65.16%（116/178）为男性。83.71%（149/178）的动静脉内瘘实现了充分成熟。16.29%（29/178）的构建内瘘发生了动静脉内瘘初次失败，其中10.11%（18/178）发生了早期血栓形成。男性患者构建远端动静脉内瘘的频率明显更高（51例对18例；p = 0.015）。女性患者明显比男性患者年龄大（63.27岁对57.86岁；p = 0.018）。
男性性别与动静脉内瘘更好的成熟度相关。CKD 4/5期患者的年龄、动静脉内瘘的数量和位置以及原发性肾脏疾病与动静脉内瘘初次失败无关。
