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大学・研究所にある論文を検索できる 「Different Risk Factors are Associated with Vascular Access Patency after Construction and Percutaneous Transluminal Angioplasty in Patients Starting Hemodialysis」の論文概要。リケラボ論文検索は、全国の大学リポジトリにある学位論文・教授論文を一括検索できる論文検索サービスです。

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Different Risk Factors are Associated with Vascular Access Patency after Construction and Percutaneous Transluminal Angioplasty in Patients Starting Hemodialysis

吉田 真帆子 広島大学

2021.03.23

概要

Background: The objective of this multicenter, prospective observational study was to determine the factors related to patency rates after construction of vascular access (VA) and the first percutaneous transluminal angioplasty (PTA).

Methods: The 24-month primary and secondary patency rates after construction of a radiocephalic arteriovenous fistula (RC-AVF) and arteriovenous graft (AVG) were evaluated using the Kaplan–Meier method and log-rank test. The 12-month post-PTA patency rate was also investigated. A Cox proportional hazard model was used to identify clinical parameters associated with the primary patency rate and the post-PTA patency rate.

Results: A total of 611 patients were enrolled in the study. The primary patency rate after VA construction was lower in hemodialysis (HD) patients with an AVG than in those with an AVF. Aging (hazard ratio [HR], 1.02 per 1 year; P<0.001), female sex (HR, 1.41; P=0.03), diabetes mellitus (HR, 1.37; P=0.03), low serum albumin (HR, 0.76 per 1-g/dL decrease; P=0.02), and use of an erythropoietin-stimulating agent (HR, 1.62; P=0.02) were risk factors for VA problems. The post-PTA patency rate was associated with aging (HR, 1.02; P<0.001), diabetes mellitus (HR, 1.49; P=0.02), polycystic kidney disease (HR, 2.14; P=0.01), temporary catheter use for initiation of HD (HR, 1.60; P=0.02), and period from VA construction to use (HR, 0.99; P=0.04).

Conclusion: Although a poor patency rate is commonly associated with advanced age and diabetes, different risk factors affect patency between VA construction and the first PTA.

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