Risk Factors for Early Access Failure of Arteriovenous Fistula in Hemodialysis Patients / 대한신장학회잡지

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 111 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.