The related factors to the re-thrombosis of hemodialysis arteriovenous graft after endovascular salvage.

IF 1.4 4区医学 Q3 UROLOGY & NEPHROLOGY

Seminars in Dialysis Pub Date : 2023-05-01 DOI:10.1111/sdi.13091

Phurich Janjindamai, Keerati Hongsakul, Jitpreedee Sungsiri, Kittipitch Bannangkoon, Tippawan Liabsuetrakul

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Abstract

Background: Only a few issues of the related factors to hemodialysis access dysfunction have been evaluated, and the effects of antiplatelets to improve the patency of hemodialysis access remained controversial. Hence, this study aimed to determine the related factors to the re-thrombosis of arteriovenous grafts (AVGs) after endovascular treatment.

Methods: This retrospective study was conducted at a university-affiliated teaching hospital in Southern Thailand. All patients who underwent hemodialysis with thrombosed AVG, who had pharmacomechanical thrombolysis from January 2016 to December 2018, were enrolled. Post-intervention primary patency was analyzed by the Kaplan-Meier method, and the related factors to the re-thrombosis of AVG were evaluated using logistic regression.

Results: A total of 157 patients with thrombosed hemodialysis AVG were enrolled. The most common graft location and configuration was a forearm loop graft (65%). Post-intervention primary patency rate at 1, 3, and 6 months were 79.0%, 67.1%, and 54.0%, respectively. Diabetes mellitus (DM) was a significant related factor for re-thrombosis (hazard ratio [HR], 1.89; 95% confidence interval [CI], 1.20-2.98; p = 0.006). A single antiplatelet after the procedure was a protective factor for re-thrombosis (HR, 0.58; 95% CI, 0.38-0.89; p = 0.013). The median post-intervention primary patency was 15.7 months in the group of single antiplatelet usage, which was better than that of the non-antiplatelet group (p = 0.012).

Conclusion: DM and antiplatelet usage were significant related factors to the re-thrombosis of hemodialysis AVG after endovascular salvage.

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血液透析动静脉移植物血管内抢救后再血栓形成的相关因素。

背景:目前对血液透析通路功能障碍的相关因素的评价较少，抗血小板药物对改善血液透析通路通畅的作用仍存在争议。因此，本研究旨在确定动静脉移植物(AVGs)血管内治疗后再血栓形成的相关因素。方法:回顾性研究在泰国南部一所大学附属教学医院进行。所有在2016年1月至2018年12月期间接受药物机械溶栓治疗的血栓性AVG患者均接受了血液透析。采用Kaplan-Meier法分析干预后初级通畅程度，采用logistic回归分析影响AVG再血栓形成的相关因素。结果:共纳入157例血栓性血液透析AVG患者。最常见的移植位置和构型是前臂环移植(65%)。干预后1个月、3个月和6个月的原发性通畅率分别为79.0%、67.1%和54.0%。糖尿病(DM)是再血栓形成的重要相关因素(危险比[HR]， 1.89;95%置信区间[CI]， 1.20-2.98;p = 0.006)。术后单一抗血小板药物是再血栓形成的保护因素(HR, 0.58;95% ci, 0.38-0.89;p = 0.013)。单抗血小板组干预后初级通畅的中位时间为15.7个月，优于非抗血小板组(p = 0.012)。结论:糖尿病和抗血小板使用是血液透析AVG血管内抢救后再血栓形成的重要因素。

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

Seminars in Dialysis 医学-泌尿学与肾脏学

CiteScore

3.00

自引率

6.20%

发文量

审稿时长

4-8 weeks

期刊介绍： Seminars in Dialysis is a bimonthly publication focusing exclusively on cutting-edge clinical aspects of dialysis therapy. Besides publishing papers by the most respected names in the field of dialysis, the Journal has unique useful features, all designed to keep you current: -Fellows Forum -Dialysis rounds -Editorials -Opinions -Briefly noted -Summary and Comment -Guest Edited Issues -Special Articles Virtually everything you read in Seminars in Dialysis is written or solicited by the editors after choosing the most effective of nine different editorial styles and formats. They know that facts, speculations, ''how-to-do-it'' information, opinions, and news reports all play important roles in your education and the patient care you provide. Alternate issues of the journal are guest edited and focus on a single clinical topic in dialysis.