Aortic Arch Calcification as a Predictor of Repeated Arteriovenous Fistula Failure within 1-Year in Hemodialysis Patients

Yap, Yit-Sheung; Ting, Kai-Ting; Chi, Wen-Che; Lin, Cheng-Hao; Liu, Yichun; Kuo, Po‐Lin; Chuang, Wan‐Long

doi:10.1155/2017/6728437

Cited by 5 publications

(5 citation statements)

References 35 publications

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“…Yap et al, found that the AAC grade was significantly associated with an older age, a history of coronary artery disease, and a higher diastolic blood pressure. Also, serum calcium levels were significantly higher in patients with high-grade ACC (21). Also, serum calcium levels were significantly higher in patients with high-grade vs. low-grade ACC, but there was no significant difference comparing the serum levels of phosphorus and albumin between the two groups (21).…”

Section: Discussionmentioning

confidence: 85%

“…Also, serum calcium levels were significantly higher in patients with high-grade ACC (21). Also, serum calcium levels were significantly higher in patients with high-grade vs. low-grade ACC, but there was no significant difference comparing the serum levels of phosphorus and albumin between the two groups (21). In another study, the AAC grade increased with age, was higher in males, and was significantly associated with a history of hypertension, diabetes, and chronic kidney disease (22).…”

Section: Discussionmentioning

confidence: 90%

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An Investigation on the One-year Rate of Arteriovenous Fistula Failure and Its Related Factors in Patients with End-stage Renal Disease; an Experience in Golestan Province of Iran

2021

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Background: Aortic arch calcification (AAC) is very common in hemodialysis patients and is associated with cardiovascular events and the incidence of arteriovenous fistula (AVF) failure. In order to predict the prognosis of patients, a study was conducted to determine the annual failure rate of AVF and its related factors. Methods: This cross-sectional study was performed on 145 patients with end-stage renal disease (ESRD) who were AVF candidates, visiting a referral center in Golestan province of Iran. After the insertion of intravenous arterial fistulas, posterior-anterior chest x-rays were captured, and the grafts were classified by a radiologist. Patients were followed for one year, and the rates of fistula failure (FF) and cardiovascular mortality were recorded. Finally, the data were entered into SPSS 19 software and analyzed by the Chi-square test. Results: Of 112 patients followed up for one year, 56.2% were men. During the one-year follow-up period, 5.3% of the patients developed arteriovenous FF, and this event was more common in men, but the difference was not statistically significant. The majority of the AVF candidates had a history of diabetes and hypertension, but no association was found between the one-year FF rate and these two diseases. Nearly 7.7% of the patients had grade III calcification, but no significant relationship was observed between the AAC grade and AVF failure rate. Conclusions: The rate of one-year FF was higher among ESRD patients with a history of chronic kidney diseases. Our results also demonstrated that the mortality rate is higher in patients with a high degree of AAC and patients with medical history (cardiovascular disease and diabetes).

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Section: Discussionmentioning

confidence: 85%

Section: Discussionmentioning

confidence: 90%

An Investigation on the One-year Rate of Arteriovenous Fistula Failure and Its Related Factors in Patients with End-stage Renal Disease; an Experience in Golestan Province of Iran

2021

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“…Except for the role of FGF21 in AVF functional patency loss, the importance of gender in predicting access patency has been well-established, with females being more prone to patency loss [ 24 ]. However, there is currently controversy regarding the relationship between serum calcium and AVF patency [ 25 , 26 ].…”

Section: Discussionmentioning

confidence: 99%

Fibroblast growth factor 21 predicts arteriovenous fistula functional patency loss and mortality in patients undergoing maintenance hemodialysis

Hu,

Ding,

Wei

et al. 2024

Renal Failure

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Background Arteriovenous fistula (AVF) dysfunction is a common complication in patients undergoing maintenance hemodialysis (MHD). Elevated serum levels of fibroblast growth factor 21 (FGF21) are associated with atherosclerosis and cardiovascular mortality. However, its association with vascular access outcomes remains elusive. The present study evaluated the relationship of serum FGF21 levels with AVF dysfunction and all-cause mortality in patients undergoing MHD. Methods We included patients undergoing MHD using AVF from January 2018 to December 2019. FGF21 concentration was detected using enzyme-linked immunosorbent assay. Patients were followed up to record two clinical outcomes, AVF functional patency loss and all-cause mortality. The follow-up period ended on April 30, 2022. Results Among 147 patients, the mean age was 58.49 ± 14.41 years, and the median serum level of FGF21 was 150.15 (70.57–318.01) pg/mL. During the median follow-up period of 40.83 months, the serum level of FGF21 was an independent risk factor for AVF functional patency loss (per 1 pg/mL increase, HR 1.002 [95% CI: 1.001–1.003, p = 0.003]). Patients with higher serum levels of FGF21 were more likely to suffer from all-cause mortality (per 1 pg/mL increase, HR 1.002 [95% CI: 1.000–1.003, p = 0.014]). The optimal cutoffs for FGF21 to predict AVF functional patency loss and all-cause mortality in patients undergoing MHD were 149.98 pg/mL and 146.43 pg/mL, with AUCs of 0.701 (95% CI: 0.606–0.796, p < 0.001) and 0.677 (95% CI: 0.595–0.752, p = 0.002), respectively. Conclusions Serum FGF21 levels were an independent risk factor and predictor for AVF functional patency loss and all-cause mortality in patients undergoing MHD.

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“…16 Calcification has also been reported to affect the patency of upper extremity arteriovenous access. 17 Prior reports have shown that wound infection is the most common complication of AVG in the thigh. The reported infection rate is 11%-41% for proximal thigh AVG 3,7-10 and 13%-21% for mid-thigh AVG.…”

Section: Discussionmentioning

confidence: 99%

“…16 Calcification has also been reported to affect the patency of upper extremity arteriovenous access. 17…”

Section: Discussionmentioning

confidence: 99%

Technique for a lateral approach to a superficial femoral artery-femoral vein thigh loop arteriovenous graft placement in avoidance of a traditional groin incision

et al. 2022

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Introduction: The number of patients with end stage renal disease reliant on long-term hemodialysis access continues to grow. When traditional upper extremity hemodialysis sites are exhausted, lower extremity access should be considered. Although autogenous lower extremity options are available, prosthetic lower extremity grafts are frequently used. However, infection can complicate a significant percentage of lower extremity grafts with a traditional groin incision. We present our technique and early results of a lateral approach to a superficial femoral artery-femoral vein thigh loop arteriovenous graft (lat-SFA-FV AVG) in the proximal thigh, which avoids a traditional groin incision and provides a functional access with promising patency. Methods: Between April 2017 and August 2019, five lat-SFA-FV AVG were placed in our institution for arteriovenous access in patients who had exhausted options in upper extremities. Results: Five patients were included in the study. Median SFA size was 8 mm. One patient had moderate SFA calcification, while the other four patients had either none or mild SFA calcification. All grafts were successfully placed with few postoperative complications, including no wound infections. One patient expired 3 weeks after the procedure due to unrelated cause. Three patients had functional grafts at a median follow-up of 499 days. Conclusion: Our early experience demonstrates that the lateral approach to the SFA-FV AVG has several advantages including avoidance of groin infection and acceptable patency. Furthermore, our early experience identifies patient factors which may be important to patient selection for this procedure.

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Aortic Arch Calcification as a Predictor of Repeated Arteriovenous Fistula Failure within 1-Year in Hemodialysis Patients

Cited by 5 publications

References 35 publications

An Investigation on the One-year Rate of Arteriovenous Fistula Failure and Its Related Factors in Patients with End-stage Renal Disease; an Experience in Golestan Province of Iran

An Investigation on the One-year Rate of Arteriovenous Fistula Failure and Its Related Factors in Patients with End-stage Renal Disease; an Experience in Golestan Province of Iran

Fibroblast growth factor 21 predicts arteriovenous fistula functional patency loss and mortality in patients undergoing maintenance hemodialysis

Technique for a lateral approach to a superficial femoral artery-femoral vein thigh loop arteriovenous graft placement in avoidance of a traditional groin incision

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