Association between Preoperative Vascular Function and Postoperative Arteriovenous Fistula Development
Association between Preoperative Vascular Function and Postoperative Arteriovenous Fistula Development
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DOI：
10.1681/asn.2015020141
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发表时间：
2016-12-01
影响因子：
13.6
通讯作者：
Feldman, Harold I.
中科院分区：
文献类型：
--
作者：
Allon, Michael;Greene, Tom;Feldman, Harold I.
动静脉瘘（AVF）成熟失败是透析血管通路功能障碍的主要原因。为了评估术前血管功能特性是否能预测术后AVF测量，参加血液透析瘘成熟研究的患者进行了多达五项术前血管功能测试（VFTs）：血流介导的扩张（FMD）、硝酸甘油介导的扩张（NMD）、颈动脉-股动脉脉波速度、颈动脉-桡动脉脉波速度和静脉闭塞容积图。我们使用混合效应多元回归分析，将术前VFT与AVF放置后1天、2周和6周的AVF血流速率和静脉直径超声测量结果联系起来。在控制了AVF位置、术前超声测量和人口统计学因素（年龄、性别、种族和透析状态）后，NMD越大，6周AVF血流率和AVF直径越大(NMD每10%的绝对差异：血流率变化=14.0%；95%置信区间[95% CI]， 3.7%至25.3%
Arteriovenous fistula (AVF) maturation failure is the primary cause of dialysis vascular access dysfunction. To evaluate whether preoperative vascular functional properties predict postoperative AVF measurements, patients enrolled in the Hemodialysis Fistula Maturation Study underwent up to five preoperative vascular function tests (VFTs): flow-mediated dilation (FMD), nitroglycerin-mediated dilation (NMD), carotid-femoral pulse wave velocity, carotid-radial pulse wave velocity, and venous occlusion plethysmography. We used mixed effects multiple regression analyses to relate each preoperative VFT to ultrasound measurements of AVF blood flow rate and venous diameter at 1 day, 2 weeks, and 6 weeks after AVF placement. After controlling for AVF location, preoperative ultrasound measurements, and demographic factors (age, sex, race, and dialysis status), greater NMD associated with greater 6-week AVF blood flow rate and AVF diameter (per absolute 10% difference in NMD: change in blood flow rate =14.0%; 95% confidence interval [95% CI], 3.7% to 25.3%; P