Autogenous Arteriovenous Fistula In Patients Receiving Hemodialysis Pathway Dysfunction Of Blood Flow Of Risk Assessment And Factor Analysis

Objective:Survey single-center MHD vascular access in patients with the status quo,risk assessment of AVF pathway dysfunction of blood flow,to discuss the influence factors of MHD patients AVF pathway dysfunction of blood flow.Methods:In March 2022-June 2022 to 17 because of AVF narrow or thrombosis at a hospital in Dali in blood purification center successful PTA or fistula should line +revascularization in patients with MHD AVF preoperative physical check,dialysis fistula limb blood vessels inside the relevant examination and colour to exceed check,extract can represent the AVF pathways the major indexes of the blood flow to the function is not good,principal component analysis is used to calculate the comprehensive score and the median.Fully regularity in the same period in 149 patients of AVF line the check and calculate the comprehensive score,according to the median scores 17 patients 149 patients AVF pathway flow function can be divided into low-risk AVF pathway crowd dysfunction group and high-risk AVF dysfunction of blood group,compared two groups of patients are related to the general data and AVF,dialysis related data,laboratory data,to discuss the influence factors of MHD patients AVF pathway dysfunction of blood flow.Result:1.This study verify blood clots blood and pulse test negative,new difficulty in piercing,tremor and unusually prompt AVF pathway dysfunction of blood flow pulsation.17 patients with median scores of 0.41,149 patients with low risk AVF pathway dysfunction group of 110(73.83%),blood flow at high risk of AVF pathway dysfunction of blood flow group 39(26.17%).2.Patients with high-risk groups of women,primary school and the following ratio higher than in low-risk group,college and above patients less than low-risk groups,the difference was statistically significant(P<0.05);Two groups of age,primary disease,diabetes mellitus/high blood pressure,smoking history comparison difference has no statistical significance(P>0.05).3.The incidence of atherosclerosis in high-risk group was higher than that in low-risk group(P<0.05).There was no significant difference in the age of fistula,anastomosis method and compression time after dialysis between the two groups(P>0.05).4.The proportion of patients with interdialytic weight gain rate>5%,ultrafiltration volume>5%,intradialytic hypotension and predialytic systolic blood pressure>140mm Hg in high-risk group was higher than that in low-risk group,and the proportion of patients with HP was lower than that in low-risk group(P<0.05).There was no significant difference in dialysis age,pre-dialysis diastolic blood pressure and post-dialysis systolic/diastolic blood pressure between the two groups(P>0.05).5.The proportion of patients with CRP≥8mg/L,ALB≤40g/L,UA≥540umol/L,LP(a)≥30mg/dl and FER>500ug/L in high-risk group was higher than that in low-risk group,and β2-MG was significantly higher than that in low-risk group(P<0.05).There was no significant difference in PCT,IL-6,HGB,PLT,FIB,D-D,Hb A1 c,TC,TG,LDL,HCY,serum calcium and phosphorus between the two groups(P>0.05).6.Female sex,predialysis systolic blood pressure ≥140mm Hg,intradialytic hypotension,ultrafiltration volume>5% and CRP≥8mg/L were risk factors for poor blood flow function of high-risk AVF access.The area under the ROC curve was 0.88,the sensitivity was 82.10%,and the specificity was 76.40%.Conclusion:1.Dialysis doctors and nurses should pay attention to the daily physical and dialysis-related examinations of AVF in MHD patients,which has new tips for dialysis centers that do not routinely carry out auxiliary examinations such as stenosis imaging.2.Gender,education level,atherosclerosis,HP,interdialytic weight gain rate,ultrafiltration volume,intradialytic hypotension,predialytic systolic blood pressure,CRP,ALB,UA,LP(a),FER,β2-MG were related factors of blood flow dysfunction in high-risk AVF.3.Female,predialysis systolic blood pressure ≥140mm Hg,intradialytic hypotension,ultrafiltration volume>5%,CRP≥8mg/L are risk factors for blood flow dysfunction of high-risk AVF access,which have certain value in predicting the risk of blood flow dysfunction of high-risk AVF access.