Bahrami-Ahmadi Amir, Khavanin Zadeh Morteza, Chehrehgosha Haleh, Abbasi Mohsen
Occupational Medicine Research Center, Iran University of Medical Sciences, Tehran, Iran.
Hasheminejad Kidney Center, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
Med J Islam Repub Iran. 2022 Aug 8;36:89. doi: 10.47176/mjiri.36.89. eCollection 2022.
Identification and control of clinical predictors of arteriovenous (AVF) failure can improve the long-term outcome of hemodialysis patients. The effects of these factors on the outcome of AVF are not still clear. So, we aimed this study to compare the effect of hypertension and diabetes on early failure of AVF. In this retrospective study, we evaluated 400 patients with ESRD referred to our clinic for the creation of the first AVF from July 14, 2001, through August 7, 2018. One month after AVF creation, the patients were referred to the clinic for patency control. Demographic characteristics, previous history of diabetes and hypertension, and laboratory data of all patients were recorded preoperatively. Data were entered to SPSS v.24 and Study data were analyzed with chi-square and independent student t-test. Then, early failure of AVF and its relationship with a history of diabetes and hypertension were assessed. There was no statistically significant relationship between the history of diabetes and early AVF failure risk in ESRD patients (OR, 0.78; 95% CI, 0.25 to 2.43). Furthermore, the history of hypertension was significantly lower in the early failure of AVF group (OR, -2.82; 95% CI, -1.42 to -5.59). Although, this effect faded when using regression analysis (OR, -2.67; 95% CI, -0.97 to -7.36). There was a higher Body mass index in the non-early failure group ( = 0.041). There was no significant difference in age ( = 0.512), gender ( = 0.091), history of smoking ( = 0.605), treatment with insulin ( = 0.683), oral antidiabetic agents ( = 0.734), duration of diabetes ( = 0.384), and duration of hypertension ( = 0.093). We reported that the history of diabetes was not higher in the early failure group, while there was a lower risk of AVF failure in patients with a previous history of hypertension.
识别并控制动静脉内瘘（AVF）失功的临床预测因素可改善血液透析患者的长期预后。这些因素对AVF预后的影响尚不清楚。因此，我们开展本研究以比较高血压和糖尿病对AVF早期失功的影响。在这项回顾性研究中，我们评估了2001年7月14日至2018年8月7日期间因首次建立AVF而转诊至我院门诊的400例终末期肾病（ESRD）患者。AVF建立后1个月，患者被转诊至门诊进行通畅性检查。术前记录所有患者的人口统计学特征、糖尿病和高血压病史以及实验室数据。数据录入SPSS v.24，研究数据采用卡方检验和独立样本t检验进行分析。然后，评估AVF早期失功及其与糖尿病和高血压病史的关系。ESRD患者的糖尿病病史与早期AVF失功风险之间无统计学显著相关性（比值比[OR]，0.78；95%置信区间[CI]，0.25至2.43）。此外，AVF早期失功组的高血压病史显著更低（OR，-2.82；95%CI，-1.42至-5.59）。不过，在进行回归分析时这种影响减弱（OR，-2.67；95%CI，-0.97至-7.36）。非早期失功组的体重指数更高（P = 0.041）。年龄（P = 0.512）、性别（P = 0.091）、吸烟史（P = 0.605）、胰岛素治疗情况（P = 0.683）、口服降糖药使用情况（P = 0.734）、糖尿病病程（P = 0.384）和高血压病程（P = 0.093）方面无显著差异。我们报告早期失功组的糖尿病病史并不更高，而既往有高血压病史的患者AVF失功风险更低。
