Impact of arteriosclerosis on the functioning of arteriovenous fistula for hemodialysis

Background/Aim. Numerous clinical studies have shown that the incidence of artheriosclerosis is higher in patients with progressive renal insufficiency. The aim of this study was to examine the incidence of artheriosclerosis in patients on chronic hemodialysis and its influence on survival and funct...

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Main Authors: Stolić Radojica, Trajković Goran, Perić Vladan, Jovanović Aleksandar, Šubarić-Gorgieva Gordana
Format: Article
Language:English
Published: Ministry of Defence of the Republic of Serbia, University of Defence, Belgrade 2007-01-01
Series:Vojnosanitetski Pregled
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Online Access:http://www.doiserbia.nb.rs/img/doi/0042-8450/2007/0042-84500701013S.pdf
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author Stolić Radojica
Trajković Goran
Perić Vladan
Jovanović Aleksandar
Šubarić-Gorgieva Gordana
author_facet Stolić Radojica
Trajković Goran
Perić Vladan
Jovanović Aleksandar
Šubarić-Gorgieva Gordana
author_sort Stolić Radojica
collection DOAJ
description Background/Aim. Numerous clinical studies have shown that the incidence of artheriosclerosis is higher in patients with progressive renal insufficiency. The aim of this study was to examine the incidence of artheriosclerosis in patients on chronic hemodialysis and its influence on survival and functioning of vascular access. Methods. The study was organized as one-year prospective study. All the patients had arteriovenous fistulas native as a vascular access. The study analyzed demographic, biochemical, clinical and Doppler echomorphological characteristics of the patients in order to make an evidence of artheriosclerotic incidences as compared to functioning arteriovenous fistulas for hemodialysis. Results. The examined patients were of the mean age 55.7±12.68 years. Of them, 53.8% were males and 46.2% females. Functioning arteriovenous fistulas for haemodialysis were found in 56.8% of the examined patients. Concentration of hemoglobin was a significant parameter of functioning fistula (group with complications - 89±14.034 vs. group with no complications - 96.6±17.71; p = 0.0489. An amount of urea removed (URR) was a statistically more significant parameter among the patients without fistula complications: (group with complications - 58.67±7.92% vs. group with no complications - 62.80±7.53%; p = 0.037). A Cox regressive analysis of an index of Doppler parameters of the carotid arteries found no statistical significance between the examined groups. There was a positive correlation between artheriosclerosis and the age, as well as the time on dialysis. In multiple regression, where intima media is a dependent and the age and time on dialysis independent variables, the regressive model was statistically significant (F = 8.22, p = 0.001). Both independent variables had statistically significant inclinations, p < 0.01. Conclusion. Anemia and the level of urea elimination, as a statistically significant indicator of hemodialysis adequacy, were in correlation with the risk for fistula complications. B-mode ultrasonography of the carotid arteries is a significant non-invasive method for detecting artheriosclerosis. Intima- media thickness of the carotid arteries was an important marker of artheriosclerosis correlating significantly with the age and time on dialysis, but not with the traditional risk factors.
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spelling doaj-art-3d2a2376a17744e6b4aa00b2ce4c3bd62025-08-20T02:39:08ZengMinistry of Defence of the Republic of Serbia, University of Defence, BelgradeVojnosanitetski Pregled0042-84502007-01-01641131810.2298/VSP0701013SImpact of arteriosclerosis on the functioning of arteriovenous fistula for hemodialysisStolić RadojicaTrajković GoranPerić VladanJovanović AleksandarŠubarić-Gorgieva GordanaBackground/Aim. Numerous clinical studies have shown that the incidence of artheriosclerosis is higher in patients with progressive renal insufficiency. The aim of this study was to examine the incidence of artheriosclerosis in patients on chronic hemodialysis and its influence on survival and functioning of vascular access. Methods. The study was organized as one-year prospective study. All the patients had arteriovenous fistulas native as a vascular access. The study analyzed demographic, biochemical, clinical and Doppler echomorphological characteristics of the patients in order to make an evidence of artheriosclerotic incidences as compared to functioning arteriovenous fistulas for hemodialysis. Results. The examined patients were of the mean age 55.7±12.68 years. Of them, 53.8% were males and 46.2% females. Functioning arteriovenous fistulas for haemodialysis were found in 56.8% of the examined patients. Concentration of hemoglobin was a significant parameter of functioning fistula (group with complications - 89±14.034 vs. group with no complications - 96.6±17.71; p = 0.0489. An amount of urea removed (URR) was a statistically more significant parameter among the patients without fistula complications: (group with complications - 58.67±7.92% vs. group with no complications - 62.80±7.53%; p = 0.037). A Cox regressive analysis of an index of Doppler parameters of the carotid arteries found no statistical significance between the examined groups. There was a positive correlation between artheriosclerosis and the age, as well as the time on dialysis. In multiple regression, where intima media is a dependent and the age and time on dialysis independent variables, the regressive model was statistically significant (F = 8.22, p = 0.001). Both independent variables had statistically significant inclinations, p < 0.01. Conclusion. Anemia and the level of urea elimination, as a statistically significant indicator of hemodialysis adequacy, were in correlation with the risk for fistula complications. B-mode ultrasonography of the carotid arteries is a significant non-invasive method for detecting artheriosclerosis. Intima- media thickness of the carotid arteries was an important marker of artheriosclerosis correlating significantly with the age and time on dialysis, but not with the traditional risk factors.http://www.doiserbia.nb.rs/img/doi/0042-8450/2007/0042-84500701013S.pdfrenal dialysisarteriovenous fistulaarteriosclerosisultrasonographydopplercarotid arterycommondemographyblood chemical analysis
spellingShingle Stolić Radojica
Trajković Goran
Perić Vladan
Jovanović Aleksandar
Šubarić-Gorgieva Gordana
Impact of arteriosclerosis on the functioning of arteriovenous fistula for hemodialysis
Vojnosanitetski Pregled
renal dialysis
arteriovenous fistula
arteriosclerosis
ultrasonography
doppler
carotid artery
common
demography
blood chemical analysis
title Impact of arteriosclerosis on the functioning of arteriovenous fistula for hemodialysis
title_full Impact of arteriosclerosis on the functioning of arteriovenous fistula for hemodialysis
title_fullStr Impact of arteriosclerosis on the functioning of arteriovenous fistula for hemodialysis
title_full_unstemmed Impact of arteriosclerosis on the functioning of arteriovenous fistula for hemodialysis
title_short Impact of arteriosclerosis on the functioning of arteriovenous fistula for hemodialysis
title_sort impact of arteriosclerosis on the functioning of arteriovenous fistula for hemodialysis
topic renal dialysis
arteriovenous fistula
arteriosclerosis
ultrasonography
doppler
carotid artery
common
demography
blood chemical analysis
url http://www.doiserbia.nb.rs/img/doi/0042-8450/2007/0042-84500701013S.pdf
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