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Risk Factors Associated with Low Vascular Access Blood Flow After Percutaneous Transluminal Angioplasty
摘要
BACKGROUND: Vascular access is a lifeline for hemodialysis patients. Percutaneous transluminal angioplasty (PTA) is an important therapeutic procedure for vascular access dysfunction. Therefore, in order to identify the factors associated with the increase of access blood flow following PTA, we conducted this retrospective study. METHODS: A total of 226 subjects receiving PTA were studied. Clinical characteristics, medical history, laboratory data, and information of vascular access were collected and analyzed. Pre- and post- PTA vascular access blood flow (VABF) were measured. RESULTS: We calculated the percentage increase of VABF post PTA and found that neither dialysis duration nor age of vascular access was correlated with the percentage increase of VABF. In multivariable binary logistic analysis, although calcium (odds ratio [OR], 0.802; 95% confidence interval [CI], 0.555-1.160; P = 0.242) and phosphorus (OR, 0.958; 95% CI, 0.764-1.201; P = 0.707) had lower ORs for the restoration of VABF post PTA, defined as a 20% increase of VABF, the associations were not significant. However, groups with diabetes (n = 98) were significantly negatively associated with the restoration of VABF post PTA (OR, 0.368; 95% CI, 0.192-0.704; P = 0.003). Besides, patients with arteriovenous graft were also less likely to have an increase in VABF post PTA (OR, 0.453; 95% CI, 0.244-0.843; P = 0.013). When we divided subjects according to the levels of VABF increment, stepwise decreases in the prevalence of diabetes were found to depend on the higher increment of VABF post PTA. In an ordinal logistic regression model, diabetes served as an independent factor negatively associated with the greater degree of increased VABF post PTA (P = 0.001). CONCLUSIONS: Our data support that among traditional risk factors of cardiovascular disease (CVD), only diabetes was a significant risk factor for low VABF post PTA. However, kidney specific risk factors of CVD such as calcium and phosphorus did not influence the VABF after PTA. Additionally, the age of vascular access and dialysis duration were also not correlated with the percentage increase in VABF.
延伸閱讀
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