Comparison of classical and non-classical cardiovascular risk factors influencing the patency of native arteriovenous fistulas after percutaneous transluminal angioplasty therapy among haemodialysis patients.
OBJECTIVE
To evaluate the classical and non-classical cardiovascular risk factors that effect patency of native arteriovenous fistulas (AVF) in end stage renal disease (ESRD) patients who are undergoing regular haemodialysis treatment and have a percutaneous transluminal angioplasty (PTA) procedure.


METHODS
All PTAs performed between 1 October 2002 and 30 September 2004 were identified from case notes and the computerised database and follow up to 31 March 2005. The definition of patency of AVF after PTA was including primary or secondary patencies. Risks were analysed to assess the influence on survival following PTAs of age, sex, serum cholesterol, serum triglyceride, diabetes, use of aspirin, current smoking and hypertension, serum albumin, serum calcium-phosphate product, intact parathyroid hormone (I-PTH), and urea reduction ratio (URR).


RESULTS
The patency rate of AVFs of all interventions was 65% at 6 months. Factors with poor patencies of AVFs after PTA procedures were higher serum calcium-phosphate product (p = 0.033), higher URR (p<0.001), lower serum albumin (p<0.001), non-hypertension (p = 0.010) and "non-smoker + ex-smoker group" (p = 0.033). The hypertensive patients and current smokers had lower patency failure after PTAs (p<0.01 and p<0.05, respectively).


CONCLUSIONS
Unfavourable cumulative patency rates are observed in haemodialysis patients with higher URR, higher serum calcium-phosphate product and hypoalbuminaemia (lower serum albumin before the PTA procedure). Hypertension and current smoking were associated with better patency rates of AVF after PTA.
Division of Nephrology, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan.
Jiung-Hsiun
JH
Liu
Po-Wen
PW
Lin
Yao-Lung
YL
Liu
Hsin-Hung
HH
Lin
Chiu-Ching
CC
Huang
D000328:Adult; D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D001163:Arteriovenous Anastomosis; D015415:Biomarkers / Q000378:metabolism; D002318:Cardiovascular Diseases / Q000209:etiology*; D002408:Catheters, Indwelling / Q000592:standards*; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000378:metabolism; D006435:Renal Dialysis / Q000379:methods*; D012189:Retrospective Studies; D012307:Risk Factors; D014654:Vascular Patency
D015415:Biomarkers; D010281:Parathyroid Hormone