Li Yu, Cui Wenhao, Wang Jukun, Zhang Chao, Luo Tao
Department of General Surgery, Xuanwu Hospital, Capital Medical University, Beijing, China.
Ann Palliat Med. 2021 Apr;10(4):4047-4054. doi: 10.21037/apm-20-2196. Epub 2021 Mar 23.
Patients in maintenance hemodialysis (MHD) need a patent vascular access for optimal treatment. Autologous arteriovenous fistula (AVF) is the optimal vascular access for patients with MHD. However, AVF dysfunction may limit its use. The aim of this article is to explore the factors associated with primary dysfunction of AVF in patients with MHD.
This is a retrospective study. A total of 121 patients who underwent anastomosis for AVF in our hospital from January 1st, 2016 through December 31st, 2018 were screened for eligibility. Of these patients, 44 were excluded according to the exclusion criteria. The remaining patients were divided into two groups based on the function of vascular access. The complete blood count and other blood biochemical parameters were compared between two groups. The risk factors associated with AVF dysfunction were analyzed by multivariate Cox proportional hazard regression model for patients with end-stage renal disease (ESRD).
There were significant differences in serum phosphorus (P), total cholesterol (TC), low density lipoprotein (LDL) and gender between patency and dysfunction groups of AVFs (P<0.05). Further multivariate COX proportional risk regression showed that hypercholesterolemia and hyperphosphatemia were independent risk factors for AVF dysfunction.
Hypercholesterolemia and hyperphosphatemia are independent risk factors for primary AVF dysfunction in patients with MHD.
维持性血液透析(MHD)患者需要有通畅的血管通路以进行最佳治疗。自体动静脉内瘘(AVF)是MHD患者的最佳血管通路。然而,AVF功能障碍可能会限制其使用。本文旨在探讨MHD患者中与AVF原发性功能障碍相关的因素。
这是一项回顾性研究。筛选了2016年1月1日至2018年12月31日在我院接受AVF吻合术的121例患者以确定其是否符合条件。在这些患者中,根据排除标准排除了44例。其余患者根据血管通路功能分为两组。比较两组的全血细胞计数和其他血液生化参数。采用多因素Cox比例风险回归模型分析终末期肾病(ESRD)患者中与AVF功能障碍相关的危险因素。
AVF通畅组和功能障碍组之间的血清磷(P)、总胆固醇(TC)、低密度脂蛋白(LDL)和性别存在显著差异(P<0.05)。进一步的多因素COX比例风险回归显示,高胆固醇血症和高磷血症是AVF功能障碍的独立危险因素。
高胆固醇血症和高磷血症是MHD患者原发性AVF功能障碍的独立危险因素。