Effect of Venoplasty on Arteriovenous Fistula Dysfunction on Quick of Blood Values of Hemodialysis Patients

Abstract

Introduction: Percutaneous transluminal angioplasty (PTA) is the gold standard in the management of AVF dysfunction. On the other hand, the management of stenosis with PTA induces an acceleration of neointimal hyperplasia with the occurrence of restenosis. The aim of this study was to assess the increase of quick of blood (Qb) hemodialysis (HD) patients after venoplasty with AVF dysfunction and its patency within 3 months post procedure, and examine the factors associated with venoplasty failure to maintain optimal Qb. Method: This study used a quasi-experimental design, in which all subjects received the treatment under study without a control group, due to ethical issues; because venoplasty is the standard protocol for AVF dysfunction in the place of this study. Qb measurements were made before and after HD, and 3 months thereafter, to evaluate AVF patency. Result: There were 25 cases that included 23 patients with 2 patients had to be re- venoplasty. An increase in Qb averaged 221.3−196.7 mL / min or about 25 mL / min in the 3-month period after venoplasty with significant results (p = 0.044). The location of stenosis in juxta anastomosis has a 14 times greater chance of venoplasty failure (p = 0.037) than stenosis in the area of draining vein or central vein. Diabetes Mellitus (DM) increased the odds of venoplasty failure 12 times greater (p = 0.038) than cases without this comorbid.. Conclusion: This study proves the increase in Qb of hemodialysis patients after venoplasty for AVF dysfunction, and it was found that the location of juxta anastomosis stenosis and the presence of DM are the two main factors that have the potential to increase the chance of venoplasty failure.

Relationship Between Quick of Blood with Arteriovenous Radiocephalic And Brachiocephalic Fistula to Blood Urea Nitrogen (BUN), Creatinine Serum, Neutrophil to Lymphocyte Ratio (NLR), And Hemoglobin in Patients Hemodialysis

“…Based on the study's results, there was no history of chronic kidney failure, COPD, HIV, malignancy, and the use of immunosuppressant drugs in the patients. This is similar to other studies which state that most hemodialysis patients experience hypertension, atherosclerosis, and diabetes mellitus 10 . Furthermore, when viewed from the comorbidity of the study sample, chronic hepatitis C is associated with higher cardiovascular-related liver disease and all causes of death in hemodialysis patients.…”

“…Most subjects in this study were male, and there was no meaningful relationship. The majority of male subjects were also found in other studies 8 and supported by other studies, which showed a significant relationship between gender and AVF access with p=0.021 10 .…”

“…. However, in the bivariate test, there was no significant relationship between the age of the subject and the type of AVF (p>0.05), where the results of this study are in line with the study of Wuwu et al, 2021 with a value of p=0.22810 . Furthermore, the average Qb in this study was 198.55 ± 23.18 ml/minute on AVF RC access and 210.88 ± 24.00 ml/minute on BC access, and there was no significant relationship between the results of the bivariate test (p> 0.05).…”

“…There was no significant relationship (p=0.716). 10 . Most subjects in this study were male, and there was no meaningful relationship.…”

“…In this study, there was no significant difference in the average rate of pumping blood in patients using AV fistula BC and RC access, both before and after venoplasty (p>0.05). 10 . However, in the study of Berman et al, (2008) found a significant difference in average access to functional and non-functional AVF BC and RC.…”