Evaluation of Risk Factors for Arteriovenous Fistula Failure in Patients Undergoing Hemodialysis
1Department of Nephrology, Akdeniz University School of Medicine, Antalya, Turkey
2Department of Nephrology, İnönü University School of Medicine, Malatya, Turkey
3Department of Radiology, İnönü University School of Medicine, Malatya, Turkey
4Department of Cardiovascular Surgery, İnönü University School of Medicine, Malatya, Turkey
J Clin Pract Res 2016; 38(1): 12-19 DOI: 10.5152/etd.2016.0052
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Abstract

Objective[|]The aim of the present study is to evaluate the relationship between demographic characteristics, hematological and biochemical parameters, and elements of the coagulation system that may predispose a person to thrombosis or to anatomical and functional parameters in Doppler ultrasonography scanning and the maturation and adequacy of arteriovenous fistulas.
[¤]Materials and Methods[|]Overall, 36 patients who underwent a native arteriovenous fistula operation were included. Biochemical parameters, hematological parameters, the coagulation system, and a Doppler ultrasonography evaluation were performed before an arteriovenous fistula operation on day 1 after the fistula operation and at the time point when the arteriovenous fistula became dysfunctional.[¤]Results[|]A thrombus occurred between 1 and 73 days (mean: 28.4±26.1) in 10 patients. It was found that the female gender (p<0.001), presence of thrill (p=0.014), quality of vein (p<0.001), peak systolic velocity and end-diastolic velocity of the radial artery at the snuffbox region on day 1 after the operation (p=0.035 and p=0.049, respectively), and the cephalic vein diameter in the Brescia–Cimino region (p=0.011) were associated with thrombosis formation. No relation was found among blood pressure, fistula region, quality of artery, spasm of artery and vein, hematologic and biochemical parameters, coagulation parameters, active protein C resistance, anti-cardiolipin antibody, D-dimer, C-reactive protein, or erythrocyte sedimentation rate and thrombosis formation (p>0.05).[¤]Conclusion[|]Thrombosis occurs at a relatively early period in approximately a quarter of arteriovenous fistulas. Female gender, quality of vein, and the absence of thrill in the post-operative period are important factors in thrombosis formation.[¤]