The risk factors for arteriovenous fistula dysfunction in maintenance hemodialysis patients: A cross-sectional study

IF 1.2 4区医学 Q3 UROLOGY & NEPHROLOGY

Hemodialysis International Pub Date : 2024-03-06 DOI:10.1111/hdi.13145

Fan Zhang, Jie Yu, Guoli Li, Shuangshuang Fu, Hailang Xiao, Yiya Yang, Yumei Liang, Yinyin Chen, Xun Luo

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Abstract

Introduction

Arteriovenous fistula (AVF) dysfunction is a prevalent complication among maintenance hemodialysis patients. However, the factors influencing AVF patency remain unclear. To address this, we conducted a study aimed at identifying factors contributing to AVF dysfunction in this patient population.

Methods

The study compared clinical data, vascular calcification score, and laboratory data focusing on blood cell composition and coagulation in 100 maintenance hemodialysis patients in whom an AVF had been inserted from January through September of 2022. The patients were divided into a group in which the AVF functioned without issues and a group in which the AVF was dysfunctional, defined as not able to provide a blood flow of greater than 200 mL/min.

Findings

Patients in the 2 groups (56 in the dysfunctional AVF group and 44 in the group with satisfactory AVF function) were similar demographically. Compared with the normally functioning AVF group, the AVF dysfunction group exhibited significantly higher Agatston calcium scores (20.5 [1.28, 298] median [Q1, Q3] vs. 1.14 [0.00, 11.6]; p = 0.01), elevated triglyceride levels (1.1 [0.6, 1.2] mmol/L vs. 0.5 [0.3, 0.8]; p < 0.01), increased prothrombin activity (113 ± 22.1% vs. 99.4 ± 23.1; p < 0.01), lower prothrombin time (10.4 [9.8, 10.8] s vs. 11.0 [10.3, 11.5]; p < 0.01), higher red blood cell (RBC) counts (3.5 ± 0.7 · 10¹²/L vs. 3.0 ± 0.7; p < 0.01), and elevated hemoglobin levels (98.0 ± 21.8 g/L vs. 84.9 ± 24.2; p < 0.01). Higher C-reactive protein (20.2 [3.3, 20.2] mg/L vs. 17.8 [6.2, 17.8]; p = 0.01) and procalcitonin levels (0.9 [0.4, 0.9] ng/mL vs. 0.5 [0.2, 0.7]; p < 0.01) were also noted. Logistic regression analysis indicated that platelet/lymphocyte ratio, monocyte/lymphocyte ratio, and RBC count were factors associated with AVF dysfunction. Increased monocyte/lymphocyte ratio and RBC count correlated with higher risk, while a higher platelet/lymphocyte ratio was associated with lower risk.

Discussion

Arteriovenous fistula dysfunction in maintenance hemodialysis patients is associated with higher proportions of specific hematological parameters, particularly elevated RBC count, and altered platelet/lymphocyte and monocyte/lymphocyte ratios.

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维持性血液透析患者动静脉瘘功能障碍的风险因素：一项横断面研究。

导言：动静脉瘘（AVF）功能障碍是维持性血液透析患者中普遍存在的并发症。然而，影响动静脉瘘通畅的因素仍不明确。为了解决这个问题，我们进行了一项研究，旨在确定导致这一患者群体动静脉瘘功能障碍的因素：该研究比较了 2022 年 1 月至 9 月期间 100 名插入了 AVF 的维持性血液透析患者的临床数据、血管钙化评分以及以血细胞成分和凝血功能为重点的实验室数据。这些患者被分为两组，一组的动静脉瓣膜功能正常，另一组的动静脉瓣膜功能失调，即不能提供大于 200 毫升/分钟的血流量：两组患者（动静脉瓣膜功能障碍组 56 人，动静脉瓣膜功能正常组 44 人）的人口统计学特征相似。与功能正常的动静脉瘘组相比，动静脉瘘功能障碍组的 Agatston 钙评分明显更高（20.5 [1.28, 298] 中位数 [Q1, Q3] vs. 1.14 [0.00, 11.6]; p = 0.01），甘油三酯水平升高（1.1 [0.6, 1.2] mmol/L vs. 0.5 [0.3, 0.8]; p 12 /L vs. 3.0 ± 0.7; p 讨论：维持性血液透析患者的动静脉内瘘功能障碍与特定血液参数比例较高有关，尤其是红细胞计数升高，以及血小板/淋巴细胞和单核细胞/淋巴细胞比率改变。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Hemodialysis International UROLOGY & NEPHROLOGY-

CiteScore

2.50

自引率

0.00%

发文量

审稿时长

6-12 weeks

期刊介绍： Hemodialysis International was originally an annual publication containing the Proceedings of the International Symposium on Hemodialysis held in conjunction with the Annual Dialysis Conference. Since 2003, Hemodialysis International is published quarterly and contains original papers on clinical and experimental topics related to dialysis in addition to the Annual Dialysis Conference supplement. This journal is a must-have for nephrologists, nurses, and technicians worldwide. Quarterly issues of Hemodialysis International are included with your membership to the International Society for Hemodialysis. The journal contains original articles, review articles, and commentary to keep readers completely updated in the field of hemodialysis. Edited by international and multidisciplinary experts, Hemodialysis International disseminates critical information in the field.