Analysis Of Risk Factors For Arteriovenous Fistula Dysfunction In Maintenance Hemodialysis Patients

Background:In recent years,with the development of economy,the change of diet habits,the aging of the population has increased and many other factors,chronic kidney disease(chronic kidney,disease,CKD)incidence increased year by year,is a public health problem cannot be underestimated.Chronic kidney diseases if poorly controlled,glomerular filtration rate continued fall,will eventually progress to end-stage renal disease,need to renal replacement therapy.In hemodialysis,peritoneal dialysis,kidney transplantation of the three renal replacement therapy,hemodialysis is the most common way.Vascular pathway is the lifeline of maintenance hemodialysis patients.Autologous arteriovenous fistula has fewer complications,higher patency rate,easier operation and lower cost.It is helpful to improve the quality of life and survival rate of patients.In view of many advantages,autologous arteriovenous internal fistula is the most commonly used internal fistula mode.The normal function of arteriovenous fistula is the key to hemodialysis treatment,it is also an important issue of concern to the Department of nephropathy,end-stage renal disease(end stage renal disease,ESRD)with autologous arteriovenous fistula vascular access is the most appropriate choice depends on the functional state.The effect of hemodialysis therapy on vascular access,it smooth or not directly affect the survival of patients on haemodialysis quality and survival rate,at the same time because of arteriovenous internal fistula dysfunction in the hospital also occupy a certain proportion of patients.So,study on risk factors of fistula dysfunction in the vein and to prevent and reduce the frequency of hospitalization in hemodialysis patients,reduce medical costs,it is of great significance to improve the quality of life of patients.Objective:Risk factors in venous fistula dysfunction patients on maintenance hemodialysis,the possible risk factors for prevention,to reduce the loss of arteriovenous fistula Occurrence rate.Methods:A retrospective study from 2016 01 months to December 2017,198 cases in the Department of nephropathy of No.1 Hospital of Jilin University in two autologous arteriovenous fistula plasty,postoperative of 3 times a week for hemodialysis patients.The study of arteriovenous internal fistula dysfunction group and patency group in sex,age,body mass index.Primary disease,hypertension,diabetes,smoking history and other basic clinical data were collected.The hemoglobin(HB),eosinophils(EOS),hematocrit(HCT),platelet(PLT),C reactive protein(CRP),plasma albumin(ALB),glycerin three greases(TG),cholesterol(TC),prothrombin time(PT),international normalized ratio(INR),analysis of fibrinogen and coagulation biochemical index,comparison of arteriovenous internal fistula dysfunction group and patent group clinical and test index is statistically significantby using Microsoft Excel software.Creating a data table.The single factor statistical analysis: statistical data by spss19.0 software.The measurement data of normal or near normal distribution in(x + s)said that the two samples were compared using independent samples t test;measurement data skewness distribution using the median(four-digit four)said,using the Wilcoxon rank sum test;count data using x2 test.By two logistic regression analysis of related factors of arteriovenous fistula dysfunction were analyzed.Results:1?ESRD in the pathogenesis of glomerulonephritis is still in the Central Plains,accounted for 36.3%;diabetic nephropathy of the second,31.3%,again 15.7%hypertensive nephropathy,interstitial nephritis in 12 cases(6.1%),9 cases of polycystic kidney(4.6%),6 cases of allergic purpura nephritis(3%),3 cases of myeloma nephropathy(1.5%),other unknown causes in 3 cases(1.5%).Data show that GN is still the leading cause of end-stage renal disease patients The main causes of hemodialysis of diabetic nephropathy,but the proportion is gradually increased,only the ratio of glomerulonephritis low 5%.Arteriovenous fistula dysfunction in the primary disease was statistically significant difference between the 2(p<0.05).2?Arteriovenous fistula dysfunction or not in gender,smoking history,body mass index,hemoglobin concentration,Hematocrit,eosinophil count,calcium phosphorus product,C reactive protein,the difference was statistically significant between the alkaline phosphatase(p<0.05).While in age,serum albumin,cholesterol,glycerin three greases,fibrinogen,prothrombin time(PT)and international normalized ratio(INR)no statistically significant differences(p>0.05).3 ? Multivariate logistic regression analysis showed that the two yuan confounding factor in controlling,hemoglobin concentration,patients with smoking history,body mass index and the calcium phosphorus product is the main risk factor for the failure of internal arteriovenous fistula(p<0.05).Conclusion:1? Maintenance hemodialysis patients with arteriovenous fistula dysfunction related to various factors,glomerulonephritis,diabetic nephropathy,hypertensive nephropathy,female,smoking history,body mass index in patients with arteriovenous fistula embolism is high.2 ? Calcium phosphorus product,C reactive protein,blood hemoglobin concentration,red hematocrit,eosinophil count,elevated ALP index,proportion of fistula dysfunction in the vein is increased,hemoglobin concentration,smoking history,body mass index and calcium phosphorus product are independent risk factors for venous fistula dysfunction.