Low Serum Albumin Levels are Associated with Short-Term Recurrence of Arteriovenous Fistula Failure.

IF 1.2 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Journal of Nippon Medical School Pub Date : 2024-01-01 DOI:10.1272/jnms.JNMS.2024_91-408

Yoshiaki Okuhata, Yukinao Sakai, Ayako Ikenouchi, Tetsuya Kashiwagi, Masato Iwabu

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引用次数: 0

Abstract

Background: Vascular access intervention therapy (VAIVT) is widely used as a treatment for arteriovenous fistula (AVF) failure. However, recurrent AVF failure is a major concern for dialysis patients. By prospectively observing patients after an initial VAIVT, we attempted to identify risk factors for developing restenosis of AVF.

Methods: This single-center prospective study evaluated 57 patients who underwent their first VAIVT procedure at our hospital from April 2022 through March 2023. We performed blood and biochemical tests during the first VAIVT to collect data on clinical variables. Ultrasonography was used to measure vessel diameter reduction rate, flow volume (FV) reduction rate, and increase in resistance index (RI) rate over a 3-month period.

Results: Within 3 months, 24 patients developed short-term shunt stenosis and 30 did not. Three were not traceable. In a comparison of the two groups, significant differences were observed in albumin (ALB), FV, RI, and elbow shunt. Analysis of change rates in the three ultrasound findings identified five factors (hematocrit, platelet count, activated partial thromboplastin time, ALB, and FV). The results of logistic regression models revealed that ALB was the most significant predictive factor for short-term shunt stenosis (p = 0.031).

Conclusion: In conclusion, our findings suggest that low serum ALB at the time of initial VAIVT is a significant risk factor for short-term recurrence of AVF failure in hemodialysis patients. These findings emphasize the importance of careful routine monitoring to reduce the risk of AVF failure and associated complications.

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血清白蛋白水平低与动静脉瘘管短期复发有关。

背景：血管通路介入疗法（VAIVT）被广泛用于治疗动静脉瘘（AVF）失败。然而，动静脉瘘复发是透析患者的一大担忧。通过前瞻性地观察初次 VAIVT 后的患者，我们试图找出发生动静脉瘘再狭窄的风险因素：这项单中心前瞻性研究评估了 2022 年 4 月至 2023 年 3 月期间在我院接受首次 VAIVT 手术的 57 名患者。我们在首次 VAIVT 期间进行了血液和生化检查，以收集临床变量数据。超声波检查用于测量3个月内血管直径缩小率、血流量（FV）缩小率和阻力指数（RI）增加率：结果：在 3 个月内，24 名患者出现短期分流狭窄，30 名患者没有出现。有 3 名患者无法追踪。两组患者在白蛋白（ALB）、FV、RI 和肘分流方面有显著差异。对三种超声检查结果的变化率进行分析后发现了五个因素（血细胞比容、血小板计数、活化部分凝血活酶时间、ALB 和 FV）。逻辑回归模型的结果显示，ALB 是预测短期分流道狭窄的最重要因素（p = 0.031）：总之，我们的研究结果表明，初次 VAIVT 时的低血清 ALB 是血液透析患者 AVF 短期内复发的重要风险因素。这些研究结果强调了认真进行常规监测以降低动静脉瘘失败及相关并发症风险的重要性。

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

Journal of Nippon Medical School MEDICINE, GENERAL & INTERNAL-

CiteScore

1.80

自引率

10.00%

发文量

118

期刊介绍： The international effort to understand, treat and control disease involve clinicians and researchers from many medical and biological science disciplines. The Journal of Nippon Medical School (JNMS) is the official journal of the Medical Association of Nippon Medical School and is dedicated to furthering international exchange of medical science experience and opinion. It provides an international forum for researchers in the fields of bascic and clinical medicine to introduce, discuss and exchange thier novel achievements in biomedical science and a platform for the worldwide dissemination and steering of biomedical knowledge for the benefit of human health and welfare. Properly reasoned discussions disciplined by appropriate references to existing bodies of knowledge or aimed at motivating the creation of such knowledge is the aim of the journal.