Analysis of Factors Related to Arteriovenous Fistula Expansion in Non-Diabetic Maintenance Hemodialysis Patients Based on Vascular Ultrasound.

Background: Maintenance hemodialysis (MHD) is an effective treatment for patients with end-stage renal disease. Although MHD can prolong the survival of patients, their quality of life is lower and the fatality rate is higher. This work analyzed the factors related to the autogenous arteriovenous fistula (AVF)-like expansion of non-diabetic MHD patients by vascular ultrasound (VUS).

Methods: A retrospective analysis of 96 non-diabetic patients with stone hemodialysis treatment was conducted. The patients were assigned to a loss group (n = 32) and a non-loss group (n = 64) based on selection criteria. The laboratory indicators, biochemical indicators, ultrasound indicators, hemodynamic indicators, and cardiac function-related indicators at 1, 3, and 6 months of patients in different groups were analyzed and compared. Logistic multivariate regression analysis (LMRA) was employed to analyze the factors influencing AVF loss. Log rank was used to test the survival time of the internal fistula.

Results: Significant differences were observed in calcium and phosphorus product, serum albumin (ALB), blood phosphorus, and C-reactive protein (CRP) between patients in different groups (P < .05), unlike urea, serum bicarbonate, blood calcium, and blood phosphorus levels (P > .05). In addition, the biochemical indexes of ferritin, unsaturated iron, serum iron, platelet, and parathyroid hormone (PTH) (P > .05). The hemodynamic indexes of patients in the two groups differed greatly (P < .05). LMRA showed that diabetes, ALB, radial diameter, and blood phosphorus were independent risk factors (IRFs) for AVF loss. Log-rank test of patients' internal fistula survival time showed that the median survival curve (MSC) of diabetic patients was lower than that of non-diabetic patients (P < .05).

Conclusion: Diabetes, ALB, radial diameter, and blood phosphorus levels were IRFs for AVF loss. Long-term AVFs were associated with hemodynamics and cardiac function to a certain extent, and appropriate flow should be selected clinically according to the patient's condition.