Type of arteriovenous vascular access and association with patency and mortality.
Type of arteriovenous vascular access and association with patency and mortality.
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DOI：
10.1186/1471-2369-14-79
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发表时间：
2013-04-04
期刊：
影响因子：
2.3
通讯作者：
Verduijn M
中科院分区：
文献类型：
--
作者：
Ocak G;Rotmans JI;Vossen CY;Rosendaal FR;Krediet RT;Boeschoten EW;Dekker FW;Verduijn M
在动静脉移植或瘘管患者中，只有少数已知的导致原发性通畅丧失的危险因素。此外，有限数量的研究调查了动静脉通路方式与原发性通畅丧失和死亡率之间的关系。本研究的目的是调查通畅丧失的危险因素，并调查移植物与瘘管使用与结果（通畅丧失和死亡率）之间的关系。我们对919例血透患者进行了前瞻性随访，并使用Cox回归计算了原发性通畅丧失推定危险因素的风险比（hr）。此外，计算hr以研究移植物与瘘管使用与2年原发性通畅丧失和2年死亡率之间的关系。心血管疾病、既往导管使用、白蛋白最低分位数、hsCRP最高分位数和胎蛋白a最低分位数与移植物和瘘管患者的原发性通畅丧失相关。年龄增加、女性和糖尿病仅与瘘管患者的原发性通畅丧失相关。我们没有观察到原发性通畅丧失与BMI、剩余GFR、钙、磷和总胆固醇水平之间的关联。此外，使用移植物与使用瘘管相比，原发性通畅丧失风险增加1.4倍（95% CI 1.0-1.9），死亡风险增加1.5倍（95% CI 1.0-2.2）。心血管疾病、既往导管使用、白蛋白、hsCRP和胎儿蛋白a是通畅丧失的危险因素。与使用瘘管相比，使用移植物会增加通畅丧失和死亡率的风险。
There are only a few risk factors known for primary patency loss in patients with an arteriovenous graft or fistula. Furthermore, a limited number of studies have investigated the association between arteriovenous access modality and primary patency loss and mortality. The aim of this study was to investigate risk factors for patency loss and to investigate the association between graft versus fistula use and outcomes (patency loss and mortality). We prospectively followed 919 incident hemodialysis patients and calculated hazard ratios (HRs) for putative risk factors of primary patency loss using Cox regression. Furthermore, HRs were calculated to study the association between graft versus fistula use and two-year primary patency loss and two-year mortality. Cardiovascular disease, prior catheter use, lowest tertile of albumin, highest tertile of hsCRP, and lowest tertile of fetuin-A were associated with primary patency loss in both patients with grafts and fistulas. Increased age, female sex, and diabetes mellitus were only associated with primary patency loss in patients with a fistula. We did not observe an association between primary patency loss and BMI, residual GFR, levels of calcium, phosphorus, and total cholesterol. Furthermore, graft use as compared with fistula use was associated with an 1.4-fold (95% CI 1.0-1.9) increased risk of primary patency loss and with an 1.5-fold(95% CI 1.0-2.2) increased mortality risk. Cardiovascular disease, prior catheter use, albumin, hsCRP, and fetuin-A are risk factors for patency loss. Graft use as compared with fistula use was associated with an increased risk of patency loss and mortality.
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影响因子：
13.6
作者：
Astor, BC;Eustace, JA;Coresh, J
通讯作者：
Coresh, J
影响因子：
13.2
作者：
Chen, Hung-Yuan;Chiu, Yen-Ling;Wu, Kwan-Dun
通讯作者：
Wu, Kwan-Dun
影响因子：
19.6
作者：
Dhingra, RK;Young, EW;Port, FK
通讯作者：
Port, FK
影响因子：
19.6
作者：
Roy-Chaudhury, P;Kelly, BS;Heffelfinger, SC
通讯作者：
Heffelfinger, SC
影响因子：
6.1
作者：
van Dijk, PCW;Jager, KJ;Briggs, JD
通讯作者：
Briggs, JD