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与动静脉内瘘建立时机相关的血液透析用动静脉内瘘:关键因素分析

ARTERIOVENOUS FISTULA FOR HEMODIALYSIS IN RELATION TO THE TIMING OF CREATION: ANALYSIS OF KEY FACTORS.

作者信息

Stolić Radojica V, Pajčin Mirjana, Mitrović Vekoslav, Zdravković Nataša D, Sovtić Saša, Marković-Jovanović Snežana, Pajović Slavica, Bulatović Kristina, Mitić Branka, Rašić Dragiša

机构信息

University of Kragujevac, Faculty of Medical Sciences, Department of Internal Medicine, Kragujevac, Serbia.

University of Pristina/Kosovska Mitrovica, Faculty of Medicine, Pristina/Kosovska Mitrovica, Serbia.

出版信息

Acta Clin Croat. 2024 Oct;63(2):368-375. doi: 10.20471/acc.2024.63.02.13.

Abstract

Timely creation of an arteriovenous fistula is not always feasible. The aim was to determine the key factors for functionality and maturation of arteriovenous fistulas in relation to timing of its creation. The research was conducted at the Department of Nephrology and Dialysis, Kragujevac University Clinical Center, Kragujevac, Serbia, in patients who had had a fistula surgically created over a period of fifteen years. A total of 1089 patients were registered. All clinical and biochemical parameters that were of interest for this study were analyzed. The group of patients with fistulas created before the start of hemodialysis was statistically different from the group of patients whose fistulas were created after the start of hemodialysis according to vein lumen (p=0.005), systolic blood pressure (p<0.001), total cholesterol (p<0.001), HDL cholesterol (p=0.008) and LDL cholesterol (p<0.001). Predictive parameters of the initial dysfunction were vein diameter (p=0.004), cholesterol (p=0.008) and LDL cholesterol (p=0.033), while the maturation parameter was systolic blood pressure (p=0.042). In conclusion, predictive parameters of initial fistula dysfunction are vein diameter, cholesterol and LDL cholesterol, while systolic blood pressure is most important for maturation.

摘要

及时建立动静脉内瘘并非总是可行的。本研究旨在确定动静脉内瘘功能和成熟的关键因素与建立时间的关系。该研究在塞尔维亚克拉古耶瓦茨大学临床中心肾病与透析科进行,研究对象为15年间接受了动静脉内瘘手术的患者。共登记了1089例患者。分析了本研究感兴趣的所有临床和生化参数。根据静脉内径(p = 0.005)、收缩压(p < 0.001)、总胆固醇(p < 0.001)、高密度脂蛋白胆固醇(p = 0.008)和低密度脂蛋白胆固醇(p < 0.001),在血液透析开始前建立内瘘的患者组与血液透析开始后建立内瘘的患者组在统计学上存在差异。初始功能障碍的预测参数为静脉直径(p = 0.004)、胆固醇(p = 0.008)和低密度脂蛋白胆固醇(p = 0.033),而成熟参数为收缩压(p = 0.042)。总之,初始内瘘功能障碍的预测参数为静脉直径、胆固醇和低密度脂蛋白胆固醇,而收缩压对成熟最为重要。

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