Kidney Research and Clinical Practice

Korean Society of Nephrology (대한신장학회)
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Risk Factors for Early Access Failure of Arteriovenous Fistula in Hemodialysis Patients

혈액투석 환자에서 동정맥루의 조기폐쇄와 관련된 위험인자 분석

Mun, Su-Yeon;Park, Byeong-Jo;Lee, Hyang-Lee;Jeong, Gyeong-Hwan;Kim, Jeong-Hui;Lee, Sang-Ho;Lee, Tae-Won;Im, Cheon-Gyu;Kim, Myeong-Jae
문수연;박병조;이향이;정경환;김정희;이상호;이태원;임천규;김명재

  • Published : 20060000
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Abstract

Background: Early failure of vascular access for hemodialysis is not uncommon. It has been known that DM, hypertension, age, sex and some abnormal laboratory findings at the surgery are the risk factors. We designed this study to analyze the risk factors for the early access failure of arteriovenous fistula (AVF). Methods: Among III patients who underwent vascular access surgery and hemodialysis at KHMC from 2000 to 2004, 106 patients with AVF were enrolled. The rate of early access failure of AVF was evaluated. Histories of DM, hypertension, cardiovascular disease, and ipsilateral central venous catheterization, medication and laboratory findings were investigated through the medical records, retrospectively and statistically analyzed.Results: The rate of early access failure of AVF was 21.3%, higher than that of AV grafts. The number of patients older than 50 years of age was greater in early access failure group. Early access failure group showed higher incidence of cardiovascular disease. Early access failure group showed higher incidence of ipsilateral central venous catheterization. Early access failure group also showed higher level of hemoglobin and hematocrit. Logistic regression analysis showed that higher hemoglobin and history of ipsilateral central venous catheterization are independent risk factors for early access failure of AVF. Conclusion: Older age at the time of surgery, history of ipsilateral central venous catheterization or cardiovascular disease and higher level of hemoglobin were associated with early access failure of AVF. History of ipsilateral central venous catheterization and higher level of hemoglobin are independent risk factors. (Korean J Nephrol 2006;25(3): 423-429)

배 경 : 혈액투석을 위한 동정맥루 또는 동정맥 인공혈관 이식의 조기폐쇄는 드물지 않으며，당뇨병， 고혈압， 나이， 성별 및 수술 시 혈액 검사 소견 등이 위험 인자로 얄려져 있다. 연구자들은 동정맥루 조기폐쇄에 영향을 마치는 수술 전 위험인자를 분석해 보고자 본 연구를 계획하였다. 방 법 2000 년부터 2004 년 6월까지 의료원에서 혈관 접근 수술 후 혈액투석을 받은 111 명의 환자， 153 개 혈관 접근 중 인공혈관 이식을 제외한 106 명， 127 개 동정맥루를 대상으로 의무 기록을 이용한 후향적 연구를 하였다. 환자들의 조기폐쇄 발생률을 조사하고， 당뇨병， 심혈관계 질환， 동측 중심정맥 삽관의 과거력， 복용 약물과 혈액 검사 등의 영향인자를 비교， 분석하였다 결 과 : 동정맥루의 조기폐쇄율은 2 1. 3% 로 동정맥 얀공혈관 이식의 7.7% 보다 유의하게 높았다 (p<0.05) 조기폐쇄군에서 수술 시 50세 이상인 경우가 조기폐쇄가 없는 군보다 유의하게 많았으며 (p<0.05) , 심혈관계 질환이 있는 경우도 1 1.1%로 많았다 (p<0.05). 조기폐쇄군에서 동측 중심정맥 삽관술을 시행한 경우가 33.3%로 조기폐쇄가 없는 군 (8.0%)보다 많았다 (p

Keywords

References

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