Development of prognostic model for fistula maturation in patients with advanced renal failure

Abstract

Background: This study aimed to explore the role of patient's characteristic and haematological factors as predictive on the maturation of arteriovenous fistulae in patients who underwent vascular access surgery at the Royal Infirmary of Edinburgh. Methods: Retrospective data from 300 patients who had undergone fistula creation between February 2007 and October 2010 was examined. A predictive logistic regression model was developed using the backward stepwise procedure. Model performance, discrimination and calibration, was assessed using the receiver operating characteristics (ROC) curve and Hosmer and Lemeshow goodness of fit test. Results: Three variables were identified which independently influenced fistula maturation. Males were twice as likely to undergo fistula maturation, compared to that of females (odds ratio (OR) 0.514; 95% confidence interval (CI) 0.308-0.857), patients with no evidence of peripheral vascular disease (PVD) were three times more likely to mature their fistula (OR 3.140; 95% CI 1.596-6.177) and a pre-operative vein diameter > 2.5 mm resulted in a fivefold increase in fistula maturation compared to a vein size less than 2.5 mm (OR 4.532; 95% CI 2.063-9.958). The model for fistula maturation had fair discrimination as indicated by the area under the ROC curve (0.68; 95% CI 0.615-0. 738) but good calibration indicated by Hosmer and Lemeshow test (p = 0.79). Conclusion: Gender, PVD and vein size are independent predictors of arteriovenous fistula maturation. The clinical utility of these risk equation in the maturation of arteriovenous fistulae requires further validation in the newly treated patients.

Brachiocephalic arteriovenous fistula maturity in end stage renal disease: The role of intraoperative brachial artery blood flow rate and peak systolic velocity

“…This is in accordance with data from USDRS in 2021 20 and the 2018 Indonesia Renal Registry report. 3 However, we found no relationship between sex and brachiocephalic AVF maturation consistent with studies by Won et al and Joannides et al 2 , 20 , 21 , 22 We also found no relationship between age and level of brachiocephalic AVF maturation consistent with studies by Chan et al and Siddiqui et al 1 , 2 , 5 , 23 …”

“…This is in accordance with data from USDRS in 2021 20 and the 2018 Indonesia Renal Registry report. 3 However, we found no relationship between sex and brachiocephalic AVF maturation consistent with studies by Won et al and Joannides et al 2,20,21,22 We also found no relationship between age and level of brachiocephalic AVF maturation consistent with studies by Chan et al and Siddiqui et al 1,2,5,23 Smoking is one of the factors that have an association with the incidence of atherosclerosis in arterial blood vessels. The quality of blood vessels can determine the maturation and patency rate of an AVF.…”

“…The quality of blood vessels can determine the maturation and patency rate of an AVF. 4 , 15 , 23 However, in this study, we found no significant relationship between smoking and brachiocephalic AVF maturation. This is consistent with a study conducted by Arhuidese et al 24 However, it was mentioned that smoking caused a decrease in the patency rate of AVF.…”

Proportions of hyperphosphatemia in different stages of chronic kidney disease

“…In the USA, over 20 million adults were reported as suffering from this disease. In the UK, the prevalence of stage 3 to 5 CKD had touched 1.7 million adults, with the annual stage 5 CKD prevalence reaching 100 per one million in population (2). Based on the Indonesian Renal Registry (IRR)'s 2018 data, there were 66 433 new patients with CKD in Indonesia (1)(2)(3).…”