Fuentes Nadia Elizabeth Saavedra, Blanco Juan Reyna, Garcia Gloria Queipo, Navarro Monserrat Perez, Gonzalez Claudia Lerma, Valdez-Ortiz Rafael
Department of Nephrology, General Hospital of Mexico Dr. Eduardo Liceaga, Mexico City, Mexico.
Department of Human Genetics, General Hospital of Mexico Dr. Eduardo Liceaga, Mexico City, Mexico.
J Ultrason. 2024 Nov 30;24(98):1-7. doi: 10.15557/jou.2024.0030. eCollection 2024 Dec.
Our objective was to determine the factors associated with the successful maturation of arteriovenous fistulas during hemodialysis.
This prospective study included patients treated with hemodialysis and predialysis patients. Clinical, biochemical, sociodemographic, vascular ultrasound mapping, flow-mediated dilatation, and surgical factors were analyzed. Success in the maturation process was defined by ultrasonographic criteria at six weeks.
Thirty-seven patients were included. With a mean ± standard deviation age of 40 ± 14 years, 73% were male, 65% had type-2 diabetes mellitus, and 95% had hypertension. Arteriovenous fistulas were brachycephalic in 18 patients (49%), brachymedian in nine patients (24%), brachycommunicating posterior in five patients (14%), brachibasal in three patients (8%), radiocephalic in two patients (8%), and radiocephalic in two patients (5%). Fourteen percent of patients had unsuccessful maturation. The vein diameter was 4.3 ± 1.0 mm (maturation group) vs 3.2 ± 0.9 mm (non-maturation group), = 0.04. The artery diameter was similar: 4.5 ± 0.6 vs 4.5 ± 0.4, = 0.88. Logistic regression analysis revealed that the diameter of the vein for which the surgery was performed was the factor associated with successful maturation in our population, odds ratio = 4.77 (1.14-19.97), -value = 0.032.
It is highly important to plan vascular access in patients to perform vascular mapping and measure veins and arteries in patients. Vein measurement is a significant factor in successful maturation of the arteriovenous fistulas.
我们的目标是确定与血液透析期间动静脉内瘘成功成熟相关的因素。
这项前瞻性研究纳入了接受血液透析治疗的患者和透析前患者。分析了临床、生化、社会人口统计学、血管超声造影、血流介导的血管扩张以及手术因素。成熟过程的成功通过六周时的超声标准来定义。
纳入了37例患者。平均年龄±标准差为40±14岁，73%为男性，65%患有2型糖尿病，95%患有高血压。动静脉内瘘为头臂型的有18例（49%），臂中位型的有9例（24%），臂后交通型的有5例（14%），臂基底型的有3例（8%），桡头型的有2例（8%），桡头型的有2例（5%）。14%的患者成熟未成功。成熟组静脉直径为4.3±1.0mm，未成熟组为3.2±0.9mm，P=0.04。动脉直径相似：4.5±0.6与4.5±0.4，P=0.88。逻辑回归分析显示，进行手术的静脉直径是我们研究人群中与成功成熟相关的因素，优势比=4.77（1.14 - 19.97），P值=0.032。
对患者进行血管通路规划并进行血管造影以及测量患者的动静脉非常重要。静脉测量是动静脉内瘘成功成熟的一个重要因素。
