Background: This study, aimed to model
associations between multiple predictor variables
and arteriovenous fistula (AVF) maturation,is
based on post-surgery data from 80 patients that
received an AVF construction for the first time by
a single surgeon. Using these data the factors
associated with successful AVF that may have an
important role in improving AVF patency rates are
elucidated.Methods: This prospective study
included 80 patients undergoing an AVF
construction for the first time by a single surgeon,
& followed them up till ascertainment of
successful AVF maturation. Multivariable logistic
regression methods were used to model
associations between multiple predictor variables
and AVF maturation. We constructed receiver
operating characteristic (ROC) curves, by plotting
sensitivity versus specificity of our model
predicting AVF maturation. We used the area
under the ROC curve (AUC) and odds ratio for
predicting optimum venous & arterial diameters
for AVF construction. Results: With an overall
AVF patency rate of 60 %, the highest patency
rates were observed in brachiobasilic AVFs
(89.50%), while brachiocephalic & radiocephalic
AVFs had patency rates of 47.10% & 55.60%
respectively. Distal venous diameter (ROC cut off)
> 2.2mm was a significant predictor of a
successful AVF. Using odds ratio, a vein having adiameter of ? 2.2mm was 4 times more likely to
yield a patent fistula. Proximal arterial diameter
(ROC cut off) > 3mm was a significant predictor
of a successful AVF. Using odds ratio, an artery
having a diameter of ? 3 mm was 3 times more
likely to yield a patent fistula. Previous central
venous catheterization, brachial artery diameter,
proximal cephalic vein diameter and distal basilic
vein flow velocity are significant predictors of a
working AVF as the final outcome. The type of
AVF constructed carries no significance as far as
prediction of a working AVF is concerned. The
age, sex, End Stage Renal Failure (ESRF),
Hypertension, Diabetes Mellitus & duration of
disease had no significance in predicting a
successful AVF.
Conclusion:
As per our study, the chances of a working AVF
were higher in patients with no previous central
venous catheterization, a distal venous diameter
of ? 2.2mm and a proximal arterial diameter of
?3mm.
Real Time Impact Factor:
Pending
Author Name: Neemesh Manohar Lodh,
URL: View PDF
Keywords: Arteriovenous fistula (AVF), Haemodialysis
ISSN: 2349-2910
EISSN:
EOI/DOI: August 2014
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