Construction of a nomograph model of impact of patency time after percutaneous balloon dilation for arteriovenous fistula stenosis

ObjectiveTo explore the influencing factors of patency time after percutaneous transluminal angioplasty (PTA) for arteriovenous fistula (AVF) stenosis and construct a nomograph prediction model.MethodsFrom February 2019 to May 2022, 125 patients receiving vascular ultrasonic evaluations and undergoi...

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Main Authors: Shu Chang -dong, Mei Ji-ben, Chen Zhong-hui, Gui Dong-dong
Format: Article
Language:zho
Published: Editorial Department of Journal of Clinical Nephrology 2025-02-01
Series:Linchuang shenzangbing zazhi
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Online Access:http://www.lcszb.com/article/doi/10.3969/j.issn.1671-2390.2025.02.002
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author Shu Chang -dong
Mei Ji-ben
Chen Zhong-hui
Gui Dong-dong
author_facet Shu Chang -dong
Mei Ji-ben
Chen Zhong-hui
Gui Dong-dong
author_sort Shu Chang -dong
collection DOAJ
description ObjectiveTo explore the influencing factors of patency time after percutaneous transluminal angioplasty (PTA) for arteriovenous fistula (AVF) stenosis and construct a nomograph prediction model.MethodsFrom February 2019 to May 2022, 125 patients receiving vascular ultrasonic evaluations and undergoing PTA for AVF stenosis were selected as study subjects and included into training set. According to the same criteria, from June to December 2022, another 42 patients (n=42) receiving vascular ultrasound included into validation set for verifying the effectiveness of the prediction model. Multivariate Cox analysis was utilized for identifying the risk factors affecting primary patency time of internal fistula post-PTA. Stepwise regression was employed for further screening important factors and constructing and validating a nomogram prediction model.ResultsPrimary patency rate was 96.0% at Month 3, 85.6% at Month 6 and 64.0% at Month 12 post-PTA. Multivariate Cox analysis results indicated that diabetes mellitus(OR=1.714,95%CI:1.034~2.308), AVF establishment time(OR=4.190,95%CI:1.684~8.807), stenotic length(OR=2.008,95%CI:1.066~3.050), maximal balloon pressure (OR=2.342,95%CI:1.107~4.078)and blood magnesium(OR=0.722,95%CI:0.620~0.823) were independent influencing factors for short patency time of internal fistula post-PTA (P<0.05). Stepwise regression analysis identified that time of AVF establishment, stenotic length, maximal balloon pressure and blood magnesium were most closely correlated with the first stage patency time of postoperative internal fistula. The evaluation results of the model hinted at a decent discrimination, a high accuracy and great effectiveness. Patients were assigned into three risk groups based on an optimal threshold, namely <112 points (low risk),≥112 points and <152 points (medium risk) and ≥152 points (high risk).ConclusionTime of AVF establishment, length of stenosis, maximal balloon pressure and blood magnesium are all most correlated with the first stage patency time of postoperative internal fistula. The nomogram prediction model based on risk factors has some clinical value.
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spelling doaj-art-2d5c9a49a04f4a93b534a2c2271aed472025-08-20T02:04:14ZzhoEditorial Department of Journal of Clinical NephrologyLinchuang shenzangbing zazhi1671-23902025-02-012529810710.3969/j.issn.1671-2390.2025.02.0021671-2390(2025)02-0098-10Construction of a nomograph model of impact of patency time after percutaneous balloon dilation for arteriovenous fistula stenosisShu Chang -dong0Mei Ji-ben1Chen Zhong-hui2Gui Dong-dong3Department of Nephrology,Xuancheng People’s Hospital, Wannan Medical College, Xuancheng 242000, ChinaDepartment of Nephrology,Xuancheng People’s Hospital, Wannan Medical College, Xuancheng 242000, ChinaDepartment of Nephrology,Xuancheng People’s Hospital, Wannan Medical College, Xuancheng 242000, ChinaDepartment of Ultrasonography, Xuancheng People’s Hospital, Wannan Medical College, Xuancheng 242000, ChinaObjectiveTo explore the influencing factors of patency time after percutaneous transluminal angioplasty (PTA) for arteriovenous fistula (AVF) stenosis and construct a nomograph prediction model.MethodsFrom February 2019 to May 2022, 125 patients receiving vascular ultrasonic evaluations and undergoing PTA for AVF stenosis were selected as study subjects and included into training set. According to the same criteria, from June to December 2022, another 42 patients (n=42) receiving vascular ultrasound included into validation set for verifying the effectiveness of the prediction model. Multivariate Cox analysis was utilized for identifying the risk factors affecting primary patency time of internal fistula post-PTA. Stepwise regression was employed for further screening important factors and constructing and validating a nomogram prediction model.ResultsPrimary patency rate was 96.0% at Month 3, 85.6% at Month 6 and 64.0% at Month 12 post-PTA. Multivariate Cox analysis results indicated that diabetes mellitus(OR=1.714,95%CI:1.034~2.308), AVF establishment time(OR=4.190,95%CI:1.684~8.807), stenotic length(OR=2.008,95%CI:1.066~3.050), maximal balloon pressure (OR=2.342,95%CI:1.107~4.078)and blood magnesium(OR=0.722,95%CI:0.620~0.823) were independent influencing factors for short patency time of internal fistula post-PTA (P<0.05). Stepwise regression analysis identified that time of AVF establishment, stenotic length, maximal balloon pressure and blood magnesium were most closely correlated with the first stage patency time of postoperative internal fistula. The evaluation results of the model hinted at a decent discrimination, a high accuracy and great effectiveness. Patients were assigned into three risk groups based on an optimal threshold, namely <112 points (low risk),≥112 points and <152 points (medium risk) and ≥152 points (high risk).ConclusionTime of AVF establishment, length of stenosis, maximal balloon pressure and blood magnesium are all most correlated with the first stage patency time of postoperative internal fistula. The nomogram prediction model based on risk factors has some clinical value.http://www.lcszb.com/article/doi/10.3969/j.issn.1671-2390.2025.02.002percutaneous transluminal angioplastyarteriovenous fistula stenosisprimary patency ratenomograph model
spellingShingle Shu Chang -dong
Mei Ji-ben
Chen Zhong-hui
Gui Dong-dong
Construction of a nomograph model of impact of patency time after percutaneous balloon dilation for arteriovenous fistula stenosis
Linchuang shenzangbing zazhi
percutaneous transluminal angioplasty
arteriovenous fistula stenosis
primary patency rate
nomograph model
title Construction of a nomograph model of impact of patency time after percutaneous balloon dilation for arteriovenous fistula stenosis
title_full Construction of a nomograph model of impact of patency time after percutaneous balloon dilation for arteriovenous fistula stenosis
title_fullStr Construction of a nomograph model of impact of patency time after percutaneous balloon dilation for arteriovenous fistula stenosis
title_full_unstemmed Construction of a nomograph model of impact of patency time after percutaneous balloon dilation for arteriovenous fistula stenosis
title_short Construction of a nomograph model of impact of patency time after percutaneous balloon dilation for arteriovenous fistula stenosis
title_sort construction of a nomograph model of impact of patency time after percutaneous balloon dilation for arteriovenous fistula stenosis
topic percutaneous transluminal angioplasty
arteriovenous fistula stenosis
primary patency rate
nomograph model
url http://www.lcszb.com/article/doi/10.3969/j.issn.1671-2390.2025.02.002
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AT chenzhonghui constructionofanomographmodelofimpactofpatencytimeafterpercutaneousballoondilationforarteriovenousfistulastenosis
AT guidongdong constructionofanomographmodelofimpactofpatencytimeafterpercutaneousballoondilationforarteriovenousfistulastenosis