title: Influence of intravenous drug abuse on native arteriovenous fistula thrombosis in chronic hemodialysis patients.
abstract: 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.
authors.affiliation: Division of Nephrology, Department of Internal Medicine, China Medical University Beigang Hospital, Yunlin, Taiwan.
authors.forename: Che-Yi
authors.initials: CY
authors.lastname: Chou
authors.forename: Yu-Hsiang
authors.initials: YH
authors.lastname: Tseng
authors.forename: Chuen-Ming
authors.initials: CM
authors.lastname: Shih
authors.forename: Chiu-Ching
authors.initials: CC
authors.lastname: Huang
authors.forename: Walter
authors.initials: W
authors.lastname: Chen
authors.forename: Wu-Long
authors.initials: WL
authors.lastname: Chang
authors.forename: Che-Wei
authors.initials: CW
authors.lastname: Hsu
mesh_terms: 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*