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Do Blood Pressure Levels and Other Patient Characteristics Influence Native Fistula Patency?
Author(s) -
Irvinn Jeyna,
Oldman Nicola,
Sedgwick Philip,
Chemla Eric
Publication year - 2013
Publication title -
seminars in dialysis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.899
H-Index - 78
eISSN - 1525-139X
pISSN - 0894-0959
DOI - 10.1111/sdi.12163
Subject(s) - medicine , blood pressure , warfarin , clopidogrel , aspirin , hemodialysis , odds ratio , fistula , cardiology , thrombosis , retrospective cohort study , surgery , atrial fibrillation
Arteriovenous fistulas ( AVF s) play an important role in access for hemodialysis, yet premature thrombosis is a challenge. This study identifies factors influencing primary patency in a series of AVF creations. Postoperative systolic blood pressure ( BP ) was of principal interest; demographical information, comorbidities, smoking status, warfarin, aspirin, clopidogrel, and statins were considered. A retrospective review of AVF creations performed by one surgeon between January 2008 and September 2010 was conducted. Fistula patency was denoted by a bruit and measured at 3 weeks and 12 months after surgery. One hundred and fifty‐one AVF creations were studied; 134 fistulas (88.7%) were patent at 3 weeks and 85 (56.3%) at 12 months. The odds ratio ( OR ) for thrombosis at 12 months was 0.16 (95% CI: 0.04, 0.62; p = 0.008) among patients with a postoperative systolic BP of 120–139 mmHg compared with those with a BP of ≤119 mmHg. Patients taking warfarin yielded an OR of 5.71 at 3 weeks (95% CI: 1.20, 27.11; p = 0.028), and 3.33 at 12 months (95% CI: 1.01, 10.99; p = 0.048). No other variables were statistically significant. Patients with postoperative systolic BP of 120–139 mmHg showed a reduction in fistula thromboses compared with patients with a systolic BP of ≤119 mmHg. Patients on warfarin were less likely to maintain a patent fistula.