Arteriovenous fistula maturation in patients with permanent access created prior to or after hemodialysis initiation

Juan C. Duque, Laisel Martinez, Marwan Tabbara, Denise Dvorquez, Sushil K. Mehandru, Arif Asif, Roberto I Vazquez-Padron, Loay Salman

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Introduction: Multiple factors and comorbidities have been implicated in the ability of arteriovenous fistulas (AVF) to mature, including vessel anatomy, advanced age, and the presence of coronary artery disease or peripheral vascular disease. However, little is known about the role of uremia on AVF primary failure. In this study, we attempt to evaluate the effect of uremia on AVF maturation by comparing AVF outcomes between pre-dialysis chronic kidney disease (CKD) stage five patients and those who had their AVF created after hemodialysis (HD) initiation. Methods: We included 612 patients who underwent AVF creation between 2003 and 2015 at the University of Miami Hospital and Jackson Memorial Hospital. Effects of uremia on primary failure were evaluated using univari-ate statistical comparisons and multivariate logistic regression analyses. Results: Primary failure occurred in 28.1% and 26.3% of patients with an AVF created prior to or after HD initiation, respectively (p = 0.73). The time of HD initiation was not associated with AVF maturation in multivariate logistic regression analysis (p = 0.57). In addition, pre-operative blood urea nitrogen (p = 0.78), estimated glomerular filtration rate (p = 0.66), and serum creatinine levels (p = 0.14) were not associated with AVF primary failure in pre-dialysis patients. Conclusions: Our results show that clearance of uremia with regular HD treatments prior to AVF creation does not improve the frequency of vascular access maturation.

Original languageEnglish (US)
Pages (from-to)185-191
Number of pages7
JournalJournal of Vascular Access
Volume18
Issue number3
DOIs
StatePublished - 2017

Fingerprint

Arteriovenous Fistula
Renal Dialysis
Uremia
Dialysis
Logistic Models
Regression Analysis
Peripheral Vascular Diseases
Blood Urea Nitrogen
Glomerular Filtration Rate
Chronic Renal Insufficiency
Blood Vessels
Comorbidity
Coronary Artery Disease
Creatinine
Anatomy

Keywords

  • Arteriovenous fistula
  • Catheter
  • Hemodialysis
  • Maturation
  • Uremia

ASJC Scopus subject areas

  • Surgery
  • Nephrology

Cite this

Arteriovenous fistula maturation in patients with permanent access created prior to or after hemodialysis initiation. / Duque, Juan C.; Martinez, Laisel; Tabbara, Marwan; Dvorquez, Denise; Mehandru, Sushil K.; Asif, Arif; Vazquez-Padron, Roberto I; Salman, Loay.

In: Journal of Vascular Access, Vol. 18, No. 3, 2017, p. 185-191.

Research output: Contribution to journalArticle

Duque, Juan C. ; Martinez, Laisel ; Tabbara, Marwan ; Dvorquez, Denise ; Mehandru, Sushil K. ; Asif, Arif ; Vazquez-Padron, Roberto I ; Salman, Loay. / Arteriovenous fistula maturation in patients with permanent access created prior to or after hemodialysis initiation. In: Journal of Vascular Access. 2017 ; Vol. 18, No. 3. pp. 185-191.
@article{85b9d9ec1981420ab7e1129c829d65a8,
title = "Arteriovenous fistula maturation in patients with permanent access created prior to or after hemodialysis initiation",
abstract = "Introduction: Multiple factors and comorbidities have been implicated in the ability of arteriovenous fistulas (AVF) to mature, including vessel anatomy, advanced age, and the presence of coronary artery disease or peripheral vascular disease. However, little is known about the role of uremia on AVF primary failure. In this study, we attempt to evaluate the effect of uremia on AVF maturation by comparing AVF outcomes between pre-dialysis chronic kidney disease (CKD) stage five patients and those who had their AVF created after hemodialysis (HD) initiation. Methods: We included 612 patients who underwent AVF creation between 2003 and 2015 at the University of Miami Hospital and Jackson Memorial Hospital. Effects of uremia on primary failure were evaluated using univari-ate statistical comparisons and multivariate logistic regression analyses. Results: Primary failure occurred in 28.1{\%} and 26.3{\%} of patients with an AVF created prior to or after HD initiation, respectively (p = 0.73). The time of HD initiation was not associated with AVF maturation in multivariate logistic regression analysis (p = 0.57). In addition, pre-operative blood urea nitrogen (p = 0.78), estimated glomerular filtration rate (p = 0.66), and serum creatinine levels (p = 0.14) were not associated with AVF primary failure in pre-dialysis patients. Conclusions: Our results show that clearance of uremia with regular HD treatments prior to AVF creation does not improve the frequency of vascular access maturation.",
keywords = "Arteriovenous fistula, Catheter, Hemodialysis, Maturation, Uremia",
author = "Duque, {Juan C.} and Laisel Martinez and Marwan Tabbara and Denise Dvorquez and Mehandru, {Sushil K.} and Arif Asif and Vazquez-Padron, {Roberto I} and Loay Salman",
year = "2017",
doi = "10.5301/jva.5000662",
language = "English (US)",
volume = "18",
pages = "185--191",
journal = "Journal of Vascular Access",
issn = "1129-7298",
publisher = "Wichtig Publishing",
number = "3",

}

TY - JOUR

T1 - Arteriovenous fistula maturation in patients with permanent access created prior to or after hemodialysis initiation

AU - Duque, Juan C.

AU - Martinez, Laisel

AU - Tabbara, Marwan

AU - Dvorquez, Denise

AU - Mehandru, Sushil K.

AU - Asif, Arif

AU - Vazquez-Padron, Roberto I

AU - Salman, Loay

PY - 2017

Y1 - 2017

N2 - Introduction: Multiple factors and comorbidities have been implicated in the ability of arteriovenous fistulas (AVF) to mature, including vessel anatomy, advanced age, and the presence of coronary artery disease or peripheral vascular disease. However, little is known about the role of uremia on AVF primary failure. In this study, we attempt to evaluate the effect of uremia on AVF maturation by comparing AVF outcomes between pre-dialysis chronic kidney disease (CKD) stage five patients and those who had their AVF created after hemodialysis (HD) initiation. Methods: We included 612 patients who underwent AVF creation between 2003 and 2015 at the University of Miami Hospital and Jackson Memorial Hospital. Effects of uremia on primary failure were evaluated using univari-ate statistical comparisons and multivariate logistic regression analyses. Results: Primary failure occurred in 28.1% and 26.3% of patients with an AVF created prior to or after HD initiation, respectively (p = 0.73). The time of HD initiation was not associated with AVF maturation in multivariate logistic regression analysis (p = 0.57). In addition, pre-operative blood urea nitrogen (p = 0.78), estimated glomerular filtration rate (p = 0.66), and serum creatinine levels (p = 0.14) were not associated with AVF primary failure in pre-dialysis patients. Conclusions: Our results show that clearance of uremia with regular HD treatments prior to AVF creation does not improve the frequency of vascular access maturation.

AB - Introduction: Multiple factors and comorbidities have been implicated in the ability of arteriovenous fistulas (AVF) to mature, including vessel anatomy, advanced age, and the presence of coronary artery disease or peripheral vascular disease. However, little is known about the role of uremia on AVF primary failure. In this study, we attempt to evaluate the effect of uremia on AVF maturation by comparing AVF outcomes between pre-dialysis chronic kidney disease (CKD) stage five patients and those who had their AVF created after hemodialysis (HD) initiation. Methods: We included 612 patients who underwent AVF creation between 2003 and 2015 at the University of Miami Hospital and Jackson Memorial Hospital. Effects of uremia on primary failure were evaluated using univari-ate statistical comparisons and multivariate logistic regression analyses. Results: Primary failure occurred in 28.1% and 26.3% of patients with an AVF created prior to or after HD initiation, respectively (p = 0.73). The time of HD initiation was not associated with AVF maturation in multivariate logistic regression analysis (p = 0.57). In addition, pre-operative blood urea nitrogen (p = 0.78), estimated glomerular filtration rate (p = 0.66), and serum creatinine levels (p = 0.14) were not associated with AVF primary failure in pre-dialysis patients. Conclusions: Our results show that clearance of uremia with regular HD treatments prior to AVF creation does not improve the frequency of vascular access maturation.

KW - Arteriovenous fistula

KW - Catheter

KW - Hemodialysis

KW - Maturation

KW - Uremia

UR - http://www.scopus.com/inward/record.url?scp=85019603054&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85019603054&partnerID=8YFLogxK

U2 - 10.5301/jva.5000662

DO - 10.5301/jva.5000662

M3 - Article

C2 - 28218361

AN - SCOPUS:85019603054

VL - 18

SP - 185

EP - 191

JO - Journal of Vascular Access

JF - Journal of Vascular Access

SN - 1129-7298

IS - 3

ER -