Do Blood Pressure Levels and Other Patient Characteristics Influence Native Fistula Patency?
Article first published online: 10 DEC 2013
© 2013 Wiley Periodicals, Inc.
Seminars in Dialysis
Volume 27, Issue 3, pages E27–E31, May–June 2014
How to Cite
Irvinn, J., Oldman, N., Sedgwick, P. and Chemla, E. (2014), Do Blood Pressure Levels and Other Patient Characteristics Influence Native Fistula Patency?. Seminars in Dialysis, 27: E27–E31. doi: 10.1111/sdi.12163
- Issue published online: 24 APR 2014
- Article first published online: 10 DEC 2013
Arteriovenous fistulas (AVFs) play an important role in access for hemodialysis, yet premature thrombosis is a challenge. This study identifies factors influencing primary patency in a series of AVF creations. Postoperative systolic blood pressure (BP) was of principal interest; demographical information, comorbidities, smoking status, warfarin, aspirin, clopidogrel, and statins were considered.
A retrospective review of AVF creations performed by one surgeon between January 2008 and September 2010 was conducted. Fistula patency was denoted by a bruit and measured at 3 weeks and 12 months after surgery.
One hundred and fifty-one AVF creations were studied; 134 fistulas (88.7%) were patent at 3 weeks and 85 (56.3%) at 12 months. The odds ratio (OR) for thrombosis at 12 months was 0.16 (95% CI: 0.04, 0.62; p = 0.008) among patients with a postoperative systolic BP of 120–139 mmHg compared with those with a BP of ≤119 mmHg. Patients taking warfarin yielded an OR of 5.71 at 3 weeks (95% CI: 1.20, 27.11; p = 0.028), and 3.33 at 12 months (95% CI: 1.01, 10.99; p = 0.048). No other variables were statistically significant.
Patients with postoperative systolic BP of 120–139 mmHg showed a reduction in fistula thromboses compared with patients with a systolic BP of ≤119 mmHg. Patients on warfarin were less likely to maintain a patent fistula.