Clinical research of arteriovenous fistula as an initial vascular access

ObjectiveTo explore the clinical characteristics and application value of arteriovenous fistula (AVF) as an initial vascular access to provide references for improving its use rate.MethodsFrom February 2016 to December 2020, retrospective analysis was performed for 170 patients with maintenance hemo...

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Main Authors: Shi You-shan, Chen Tian-hao, Huang Zheng
Format: Article
Language:zho
Published: Editorial Department of Journal of Clinical Nephrology 2022-06-01
Series:Linchuang shenzangbing zazhi
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Online Access:http://www.lcszb.com/thesisDetails#10.3969/j.issn.1671-2390.2022.06.006
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author Shi You-shan
Chen Tian-hao
Huang Zheng
author_facet Shi You-shan
Chen Tian-hao
Huang Zheng
author_sort Shi You-shan
collection DOAJ
description ObjectiveTo explore the clinical characteristics and application value of arteriovenous fistula (AVF) as an initial vascular access to provide references for improving its use rate.MethodsFrom February 2016 to December 2020, retrospective analysis was performed for 170 patients with maintenance hemodialysis (MHD). There were 114 males and 56 females with an average age of (61.68±14.79)(20-92) years. According to the difference of vascular access for initial dialysis, they were divided into two groups of AVF and central venous catheter (CVC). Demographic profiles, clinical data, laboratory examinations, major risk events and mortality within 1 year of two groups were compared.ResultsIn AVF group (<italic>n</italic>=51), there were 33 males and 18 females with an average age of (61.71±12.05) years; In CVC group (<italic>n</italic>=119), there were 81 males and 38 females with an average age of (61.67±15.87) years. No significant inter-group differences existed in composition ratio of gender, age or primary disease (<italic>P</italic>&gt;0.05). Using rate of AVF for initial vascular access was 30.00%. AVF group had higher education and better economic status and the difference was statistically significant (<italic>P</italic>&lt;0.05). The follow-up period of 27(12-72) months was longer than that of control group (<italic>P</italic>&lt;0.05). Serum albumin(37.87±0.72)g/L and eGFR(7.11±2.53)mL·min<sup>-1</sup>·(1.73m<sup>2</sup>)<sup>-1 </sup>were higher in AVF group than those in control group (<italic>P</italic>&lt;0.05). Systolic blood pressure (144.33±16.20) mmHg was better than those of control group and the difference was statistically significant (<italic>P</italic>&lt;0.05). Multivariate analysis suggested that eGFR (<italic>OR</italic>=0.620, <italic>P</italic>=0.031), serum albumin (<italic>OR</italic>=0.790, <italic>P</italic>=0.003) and systolic blood pressure (<italic>OR</italic>=1.030, <italic>P</italic>=0.001) were independent factors in selecting AVF as an initial vascular access. Within 1 year of dialysis, no death occurred in AVF group and 12 deaths in control group. The difference was statistically significant (<italic>P</italic>&lt;0.05). The occurrence of major risk events such as cardiovascular and cerebrovascular events, lung infections and vascular access infections was lower than that in control group (<italic>P</italic>&lt;0.05).ConclusionSelecting vascular access is correlated with eGFR, serum albumin and systolic blood pressure at this center. And choosing AVF as an initial vascular pathway plays some role in reducing the occurrence of major risk events and death.
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spelling doaj-art-5b2221dc74df4bc6bbccf38e27b04c572025-08-20T02:28:47ZzhoEditorial Department of Journal of Clinical NephrologyLinchuang shenzangbing zazhi1671-23902022-06-012247848328234767Clinical research of arteriovenous fistula as an initial vascular accessShi You-shanChen Tian-haoHuang ZhengObjectiveTo explore the clinical characteristics and application value of arteriovenous fistula (AVF) as an initial vascular access to provide references for improving its use rate.MethodsFrom February 2016 to December 2020, retrospective analysis was performed for 170 patients with maintenance hemodialysis (MHD). There were 114 males and 56 females with an average age of (61.68±14.79)(20-92) years. According to the difference of vascular access for initial dialysis, they were divided into two groups of AVF and central venous catheter (CVC). Demographic profiles, clinical data, laboratory examinations, major risk events and mortality within 1 year of two groups were compared.ResultsIn AVF group (<italic>n</italic>=51), there were 33 males and 18 females with an average age of (61.71±12.05) years; In CVC group (<italic>n</italic>=119), there were 81 males and 38 females with an average age of (61.67±15.87) years. No significant inter-group differences existed in composition ratio of gender, age or primary disease (<italic>P</italic>&gt;0.05). Using rate of AVF for initial vascular access was 30.00%. AVF group had higher education and better economic status and the difference was statistically significant (<italic>P</italic>&lt;0.05). The follow-up period of 27(12-72) months was longer than that of control group (<italic>P</italic>&lt;0.05). Serum albumin(37.87±0.72)g/L and eGFR(7.11±2.53)mL·min<sup>-1</sup>·(1.73m<sup>2</sup>)<sup>-1 </sup>were higher in AVF group than those in control group (<italic>P</italic>&lt;0.05). Systolic blood pressure (144.33±16.20) mmHg was better than those of control group and the difference was statistically significant (<italic>P</italic>&lt;0.05). Multivariate analysis suggested that eGFR (<italic>OR</italic>=0.620, <italic>P</italic>=0.031), serum albumin (<italic>OR</italic>=0.790, <italic>P</italic>=0.003) and systolic blood pressure (<italic>OR</italic>=1.030, <italic>P</italic>=0.001) were independent factors in selecting AVF as an initial vascular access. Within 1 year of dialysis, no death occurred in AVF group and 12 deaths in control group. The difference was statistically significant (<italic>P</italic>&lt;0.05). The occurrence of major risk events such as cardiovascular and cerebrovascular events, lung infections and vascular access infections was lower than that in control group (<italic>P</italic>&lt;0.05).ConclusionSelecting vascular access is correlated with eGFR, serum albumin and systolic blood pressure at this center. And choosing AVF as an initial vascular pathway plays some role in reducing the occurrence of major risk events and death.http://www.lcszb.com/thesisDetails#10.3969/j.issn.1671-2390.2022.06.006Arteriovenous fistulaVascular accessInitial hemodialysis
spellingShingle Shi You-shan
Chen Tian-hao
Huang Zheng
Clinical research of arteriovenous fistula as an initial vascular access
Linchuang shenzangbing zazhi
Arteriovenous fistula
Vascular access
Initial hemodialysis
title Clinical research of arteriovenous fistula as an initial vascular access
title_full Clinical research of arteriovenous fistula as an initial vascular access
title_fullStr Clinical research of arteriovenous fistula as an initial vascular access
title_full_unstemmed Clinical research of arteriovenous fistula as an initial vascular access
title_short Clinical research of arteriovenous fistula as an initial vascular access
title_sort clinical research of arteriovenous fistula as an initial vascular access
topic Arteriovenous fistula
Vascular access
Initial hemodialysis
url http://www.lcszb.com/thesisDetails#10.3969/j.issn.1671-2390.2022.06.006
work_keys_str_mv AT shiyoushan clinicalresearchofarteriovenousfistulaasaninitialvascularaccess
AT chentianhao clinicalresearchofarteriovenousfistulaasaninitialvascularaccess
AT huangzheng clinicalresearchofarteriovenousfistulaasaninitialvascularaccess