Analysis Of The Risk Factors Of The Late Artefiovenous Fistula Dysfunction From A Single Center

Objective:To provide a theoretical basis for prolonging the service life of autologous arteriovenous fistula(AVF)of maintenance hemodialysis(MHD)patients,we collect relevant clinical indicators of MHD patients who using AVF,then analyze the relationship between various indicators and the late AVF dysfunction and screen out the risk factors that affect the life of AVF.Methods:This study is retrospective study.From October 2004 to June 2017,187 patients undergoing AVF at the First Affiliated Hospital of Nanchang University and using AVF to maintain hemodialysis were selected as study subjects to study risk factors for patients with late stage AVF failure.By referring to the hospital case system,hemodialysis record sheets,and questionnaire surveys,the general data,AVF surgery-related data,dialysis-related data,and laboratory indicators were collected,and then the patients were classified into the patency group and the disability group according to the function of their AVF.A database was established by Excel software and statistical was analyzed by using SPSS 24.0 software.Measurement data and count data were compared using independent sample t-test and chi-square test.For screening risk factors,first use single factor logistic regression to compare the two groups of influential factors,and then carry out multi-factor logisc regression,The statistical result p<0.05 was considered statistically significant.Results :1.Logistic single-factor regression results showed that there was a statistically significant difference between the patency group and the failure group for diabetes(p=0.001)and serum albumin(p=0.001)(P<0.05).2.Logistic multivariate regression analysis showed that there was a statistically significant difference between the patency group and the failure group for diabetes(p=0.001,OR=3.266)and serum albumin(p=0.002,OR=0.881).Patients with diabetes and hypoalbumin are risk factors for late stage loss of autologous AVF.Conclusion:1.Diabetes is a risk factor for late failure of AVF in MHD patients.Patients with poor glycaemic control are more likely to lose power of AVF.2.Plasma albumin is a risk factor of AVF dysfunction in MHD patients.Too low or too high levels of plasma albumin can affect the service life of AVF.The extent of minimal effect of albumin on internal hemorrhoids remains to be further studied.