The aim of the study was to assess the potential predictive factors for early arteriovenous fistula (AVF) failure following the fistula first initiative. We retrospectively reviewed the data of 159 end-stage renal disease (ESRD) patients who underwent AVF creation. The preoperative factors such as demographic, comorbidity condition, laboratory parameters and medication, and intraoperative or surgical-related factors were assessed. In multivariate logistic regression analysis, significant predictive factors of early AVF failure were female gender (odds ratio (95% confidence interval): 2.63 (1.19-5.81); P = 0.017), higher body mass index (P = 0.038), and lower hemoglobin level (P = 0.048), while adjusting for preoperative factors or all factors. For adjusting of intraoperative factors, reduced venous diameter (P = 0.056) tended to be associated with early AVF failure. In conclusion, female gender, higher body mass index and lower hemoglobin level predicted the occurrence of early AVF failure in ESRD patients.
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http://dx.doi.org/10.1111/1744-9987.12323 | DOI Listing |
Nat Commun
January 2025
Querrey Simpson Institute for Bioelectronics, Northwestern University, Evanston, IL, USA.
Hemodialysis for chronic kidney disease (CKD) relies on vascular access (VA) devices, such as arteriovenous fistulas (AVF), grafts (AVG), or catheters, to maintain blood flow. Nonetheless, unpredictable progressive vascular stenosis due to neointimal formation or complete occlusion from acute thrombosis remains the primary cause of mature VA failure. Despite emergent surgical intervention efforts, the lack of a reliable early detection tool significantly reduces patient outcomes and survival rates.
View Article and Find Full Text PDFAnn Vasc Surg
December 2024
Department of Surgery and Physiology, Faculty of Medicine, University of Porto, Porto, Portugal; Department of Angiology and Vascular Surgery, Centro Hospitalar de Trás os Montes e Alto Douro, Vila Real, Portugal.
Autogenous arteriovenous fistula (AVF) is the vascular access of choice for chronic kidney disease to patients requiring hemodialysis. However, there still needs to be more consensus on whether the best surgical approach is an end-of-vein to side-of-artery (ETS) or a side-of-vein to side-of-artery (STS) anastomosis. This study aims to compare venous maturation rates, mid-term patency and post-operative steal syndrome rates between ETS and STS techniques for arteriovenous fistulas.
View Article and Find Full Text PDFDiabetes Metab Syndr Obes
December 2024
Department of Nephrology, Baoding No 1 Central Hospital, Baoding, Hebei, People's Republic of China.
Background: This research aimed to identify risk factors contributing to premature maturation of arteriovenous fistulas (AVF) in elderly diabetic patients and develop a clinical prediction model.
Methods: We conducted a retrospective review of 548 geriatric diabetic patients who underwent AVF creation for maintenance hemodialysis (MHD) at Baoding No 1 Central Hospital between January 2011 and December 2023. Patients were divided into mature (386) and immature (162) groups based on AVF maturation status.
Cureus
November 2024
Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, USA.
Distal hypoperfusion ischemic syndrome (DHIS), also known as dialysis access steal syndrome (DASS), is a rare but significant complication in patients with end-stage renal disease (ESRD) undergoing hemodialysis through arteriovenous fistulas (AVFs). This case report presents a female patient in her 40s with a complex medical history, including peripheral arterial disease, coronary artery disease, and recurrent cellulitis affecting her right hand, who developed DHIS following the placement of a brachiobasilic AVF. Despite optimal medical management, the patient exhibited persistent ischemic symptoms, including hand coolness and necrosis, ultimately requiring surgical ligation of the AVF.
View Article and Find Full Text PDFAnn Vasc Surg
December 2024
Sheffield Kidney Institute, Northern General Hospital, Herries Road, Sheffield, United Kingdom, S5 7AU.
Obesity is growing in Haemodialysis population. Few scholars report variable effect of increased Body Mass Index (BMI) on native fistula. Reports on obesity effect on Arteriovenous Graft (AVG) patency are lacking.
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