Influence of intravenous drug abuse on native arteriovenous fistula thrombosis in chronic hemodialysis patients.
The influence of intravenous drug abuse (IVDA) on native arteriovenous fistula thrombosis (NAT) in chronic hemodialysis patients is unknown. We conducted a retrospective study of 123 chronic hemodialysis patients incarcerated in a male prison in Mid-Taiwan. All patients were dialyzed three times per week, 4 h per session. The development of NAT was compared in patients with a history of IVDA (42, 34.1%) and those without (81, 65.9%). A total of 36 patients experienced one or more NAT episodes in 6 years and 29 (80.6%) of them had a history of IVDA. In these 29 patients, 22 (75.9%) relied on repeated thrombectomy or thrombolysis therapy to maintain patent vascular access. In Kaplan-Meier survival analysis, patients with a history of IVDA were prone to develop NAT (log-rank, P < 0.001). The result of Cox regression suggested that a history of IVDA, independent of diabetes, was associated with the development of NAT. Patients with a history of IVDA, even after IVDA has stopped, were still prone to develop NAT and vascular access infection.
Chou
Che-Yi
CY
Division of Nephrology, Department of Internal Medicine, China Medical University Beigang Hospital, Yunlin, Taiwan.
Tseng
Yu-Hsiang
YH
Shih
Chuen-Ming
CM
Huang
Chiu-Ching
CC
Chen
Walter
W
Chang
Wu-Long
WL
Hsu
Che-Wei
CW
D000328:Adult; D001166:Arteriovenous Shunt, Surgical / Q000009:adverse effects*; D001424:Bacterial Infections / Q000209:etiology; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011330:Prisons; D016016:Proportional Hazards Models; D006435:Renal Dialysis; D012189:Retrospective Studies; D015819:Substance Abuse, Intravenous / Q000150:complications*; D013624:Taiwan; D017131:Thrombectomy; D015912:Thrombolytic Therapy; D013927:Thrombosis / Q000209:etiology*