Survival Analysis Of The Arteriovenous Fistula In Hemodialysis Patients

BackgroundAlthough the arteriovenous fistula is the best maintenance of vascular access, But in recent years as the population ages and the incidence of diabetes and high blood pressure elevation, Renal failure and hypertension aged more atherosclerosis, vein thin, exhausted, the situation is difficult to build increasing fistula, Arteriovenous fistula complications such as venous steal syndrome, stenosis, and vascular tumors, congestive heart failure, are still unavoidable. Therefore, how to establish and maintain an ideal place in the dialysis vascular access is an important issue before workers. This paper analyzes a number of life of patients with fistula, And in Kaplan-Meier analysis, Identify the various factors, prolong fistula life for dialysis patients for more time.ObjectiveUnderstanding of hemodialysis patients autologous arteriovenou fistula within the using life.2.To study the effect of hemodialysis patients autologous arteriovenous fistula longevity within the related factors.MethodsA retrospective study in our line autologous arteriovenous fistula (angioplasty and within in hemodialysis patients maintain within the situation and fistula various influential factors, Records of the using life and analyzed their survival by Kaplan-Meier we calculated the mean and median lifetime of the catheter with a 95% confidence interval(95% CI) and their P value. And multiple regression analysis for COX.Results(1)In our hospital from the arteriovenous fistula operation and maintenance hemodialysis in our hospital's 150 patients, including 40 cases of fistula loss of function. Loss of function causes: 38 cases, thrombosis, 6 cases of stenosis, limb edema and 1 case of refractory. (2)150 cases of arteriovenous fistula in patients 1 year survival rate was 81.8%, 5 year survival rate was 35.4%. 40 cases of fistula in patients with loss of function of the median survival time of 285±101.940 days, 95% confidence interval (85.199-484.801).(3) 40 cases of fistula in patients with loss of function analysis of Kaplan-meier. The results showed that: HCT, TRIG, PLT, CRP, age, fistula diameter, blood flow within the fistula, the incidence of dialysis hypotension, is suffering from diabetes, heparin dosage, fistula use during the hospital stay, the above factors, the difference was statistically significance. COX regression analysis showed that the internal fistula survival time have a significant effect of risk factors were: dialysis hypotension, HCT, blood flow within the fistula, CRP, diabetes, blood lipid.(4) Within the fistula, the median survival time were divided into two groups, two groups of HCT, TRIG, CHOL, age, dialysis blood flow, dialysis hypotension significant difference in incidence. Two CO, CI, LVD cardiac function were statistically significant differences . Correlation analysis showed: HCT, TRIG, CHOL, PLT, HGB, CRP, blood flow within the fistula, age, fistula diameter, the incidence of dialysis hypotension and fistula survival time correlated .(5) (5) Fistula in 40 patients after cardiac output (CO), cardiac index (CI) increased significantly compared with the preoperative, statistically significant (P <0.05), left atrial diameter (LAD), left ventricular diameter (LVD), left ventricular end diastolic volume (LVEDV) in arteriovenous fistula after operation is enlarged (P <0.05), statistically significant.(6) Fistula in 48 patients assessing the adequacy of dialysis patients (40 patients except for two cases of fistula dysfunction in patients not used), blood flow to 200-320ml/mim case, urea reduction rate of URR70.8%, dialysis adequacy of Kt / V average of 1.45.Conclusion :150 cases of arteriovenous fistula in patients 1 year survival rate was 81.8%, 5 year survival rate was 35.4%. 40 cases of fistula in patients with loss of function of the median survival time of 285±101.940 days, mainly to the early loss of function. Kaplan-meier analysis showed: HCT, TRIG, PLT, CRP, age, fistula diameter, blood flow within the fistula, the incidence of dialysis hypotension, is suffering from diabetes, heparin dosage, fistula use during the hospital stay, these factors fistula significantly affected survival. Arteriovenous fistula hemodialysis patients can cause cardiac output, cardiac index increased, the left atrial and ventricular cavity enlargement and left ventricular end diastolic volume increases. URR average of 38 cases 70.8%, Kt / V averaged 1.45...