Predictors of arteriovenous fistula maturation in hemodialysis patients: a prospective cohort from an ambulatory surgical center in Joinville, Brazil
ABSTRACT Introduction: The high rate of arteriovenous fistula maturation failure is a concern in a scenario of growing numbers of patients on hemodialysis. Non-vascular factors tied to maturation success have not been fully discussed. Methods: This prospective observational cohort study included p...
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| Format: | Article |
| Language: | English |
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Sociedade Brasileira de Nefrologia
2022-12-01
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| Series: | Brazilian Journal of Nephrology |
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| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0101-28002022005062401&tlng=en |
| _version_ | 1797980856537579520 |
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| author | Claudete Gasparin Helbert do Nascimento Lima Ademar Regueira Filho Alexandre Gustavo Baggenstoss Marques Gilmar Erzinger |
| author_facet | Claudete Gasparin Helbert do Nascimento Lima Ademar Regueira Filho Alexandre Gustavo Baggenstoss Marques Gilmar Erzinger |
| author_sort | Claudete Gasparin |
| collection | DOAJ |
| description | ABSTRACT Introduction: The high rate of arteriovenous fistula maturation failure is a concern in a scenario of growing numbers of patients on hemodialysis. Non-vascular factors tied to maturation success have not been fully discussed. Methods: This prospective observational cohort study included patients with CKD on dialysis or pre-dialysis prescribed arteriovenous fistula creation for the first time in an ambulatory surgical center in Joinville, Brazil, from January 2021 to July 2021. Anthropometric aspects, sociodemographic characteristics, comorbidities, and vascular parameters observed in Doppler ultrasound were analyzed. Variables associated with maturation were analyzed in multivariate models by logistic regression. Results: Eighty-eight of 145 participants (60.1%) were males. Included patients had a median age of 59 years. Successful arteriovenous fistula maturation occurred in 113 (77.9%) patients. Factors such as increased BMI, hematocrit, arm circumference, and skinfold thickness were associated with lower chances of arteriovenous fistula maturation in univariate analysis. On the other hand, larger vein and artery diameter and fistulas in the more proximal portion of the arm were associated with higher maturation success. In multivariate analysis, smoking and larger skinfold and arm circumference were associated with lower chances of successful maturation. Increased systolic blood pressure and vein diameter were associated with greater chance of success. Conclusion: In addition to the vascular parameters assessed in Doppler ultrasonography, factors related to obesity and/or nutritional aspects may influence arteriovenous fistula maturation. |
| first_indexed | 2024-04-11T06:01:28Z |
| format | Article |
| id | doaj.art-f95e13aeb9cc4993a78ed8eea7883c03 |
| institution | Directory Open Access Journal |
| issn | 2175-8239 |
| language | English |
| last_indexed | 2024-04-11T06:01:28Z |
| publishDate | 2022-12-01 |
| publisher | Sociedade Brasileira de Nefrologia |
| record_format | Article |
| series | Brazilian Journal of Nephrology |
| spelling | doaj.art-f95e13aeb9cc4993a78ed8eea7883c032022-12-22T04:41:40ZengSociedade Brasileira de NefrologiaBrazilian Journal of Nephrology2175-82392022-12-0110.1590/2175-8239-jbn-2022-0120enPredictors of arteriovenous fistula maturation in hemodialysis patients: a prospective cohort from an ambulatory surgical center in Joinville, BrazilClaudete Gasparinhttps://orcid.org/0000-0003-0321-9887Helbert do Nascimento Limahttps://orcid.org/0000-0003-0081-6897Ademar Regueira Filhohttps://orcid.org/0000-0002-5113-2447Alexandre Gustavo Baggenstoss MarquesGilmar Erzingerhttps://orcid.org/0000-0001-6262-4677ABSTRACT Introduction: The high rate of arteriovenous fistula maturation failure is a concern in a scenario of growing numbers of patients on hemodialysis. Non-vascular factors tied to maturation success have not been fully discussed. Methods: This prospective observational cohort study included patients with CKD on dialysis or pre-dialysis prescribed arteriovenous fistula creation for the first time in an ambulatory surgical center in Joinville, Brazil, from January 2021 to July 2021. Anthropometric aspects, sociodemographic characteristics, comorbidities, and vascular parameters observed in Doppler ultrasound were analyzed. Variables associated with maturation were analyzed in multivariate models by logistic regression. Results: Eighty-eight of 145 participants (60.1%) were males. Included patients had a median age of 59 years. Successful arteriovenous fistula maturation occurred in 113 (77.9%) patients. Factors such as increased BMI, hematocrit, arm circumference, and skinfold thickness were associated with lower chances of arteriovenous fistula maturation in univariate analysis. On the other hand, larger vein and artery diameter and fistulas in the more proximal portion of the arm were associated with higher maturation success. In multivariate analysis, smoking and larger skinfold and arm circumference were associated with lower chances of successful maturation. Increased systolic blood pressure and vein diameter were associated with greater chance of success. Conclusion: In addition to the vascular parameters assessed in Doppler ultrasonography, factors related to obesity and/or nutritional aspects may influence arteriovenous fistula maturation.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0101-28002022005062401&tlng=enRenal InsufficiencyChronicRenal DialysisArteriovenous FistulaUltrasonography |
| spellingShingle | Claudete Gasparin Helbert do Nascimento Lima Ademar Regueira Filho Alexandre Gustavo Baggenstoss Marques Gilmar Erzinger Predictors of arteriovenous fistula maturation in hemodialysis patients: a prospective cohort from an ambulatory surgical center in Joinville, Brazil Brazilian Journal of Nephrology Renal Insufficiency Chronic Renal Dialysis Arteriovenous Fistula Ultrasonography |
| title | Predictors of arteriovenous fistula maturation in hemodialysis patients: a prospective cohort from an ambulatory surgical center in Joinville, Brazil |
| title_full | Predictors of arteriovenous fistula maturation in hemodialysis patients: a prospective cohort from an ambulatory surgical center in Joinville, Brazil |
| title_fullStr | Predictors of arteriovenous fistula maturation in hemodialysis patients: a prospective cohort from an ambulatory surgical center in Joinville, Brazil |
| title_full_unstemmed | Predictors of arteriovenous fistula maturation in hemodialysis patients: a prospective cohort from an ambulatory surgical center in Joinville, Brazil |
| title_short | Predictors of arteriovenous fistula maturation in hemodialysis patients: a prospective cohort from an ambulatory surgical center in Joinville, Brazil |
| title_sort | predictors of arteriovenous fistula maturation in hemodialysis patients a prospective cohort from an ambulatory surgical center in joinville brazil |
| topic | Renal Insufficiency Chronic Renal Dialysis Arteriovenous Fistula Ultrasonography |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0101-28002022005062401&tlng=en |
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