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Plasma D‐Dimer Level and the Failure of Forearm Autologous Arteriovenous Fistula in Patients With End‐Stage Renal Disease
Author(s) -
Du Jing,
Kong Xianglei,
Liang Liming,
Chen Qinlan,
Yin Lili,
Xu Dongmei
Publication year - 2020
Publication title -
therapeutic apheresis and dialysis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.415
H-Index - 53
eISSN - 1744-9987
pISSN - 1744-9979
DOI - 10.1111/1744-9987.13454
Subject(s) - medicine , hemodialysis , arteriovenous fistula , forearm , proportional hazards model , surgery , retrospective cohort study , confounding , cohort , log rank test , d dimer
Failed autologous arteriovenous fistula (AVF) is a major issue in the creation of functional hemodialysis vascular access. To date, the relationship between D‐dimer and AVF failure is still uncertain. Hence, we conducted a retrospective cohort study to explore the patency rate of forearm AVFs and to clarify whether plasma D‐dimer level can predict the failure of AVFs. In this study, 290 ESRD patients (the mean age 54.1 ± 14.6 years, 63.8% of them were males) receiving forearm AVFs surgery were consecutively enrolled with a median follow‐up time of 34 months. Primary patency rates and risk factors associated with AVFs failure were explored by the Kaplan–Meier method or Cox proportional hazards model. Patients were divided into two groups based on the median level of D‐dimer (group 1 <1.1 mg/L and group 2 ≥1.1 mg/L). The Kaplan–Meier survival analysis demonstrated that the patency of AVF in group 1 was similar in group 2, which were 92.4% versus 88.9%, 84.8% versus 84.0%, 80.0% versus 79.2%, 76.7% versus 78.5%, and 76.7% versus 78.5% at 12, 24, 36, 48, and 60 months (Log‐rank test, P = 0.8), respectively. In the crude analysis, D‐dimer (per 1 mg/L increase) was independently associated with AVFs failure, with OR of 1.08 (95% CI, 1.02–1.15). However, after adjusting for potential confounders, the D‐dimer (per 1 mg/L increase) was not associated with the AVFs failure (OR = 1.06, 95% CI = 0.99–1.13). This study did not find that the plasma D‐dimer level can predict the failure of forearm AVFs.