To Analyze The Current Status Of Frailty In Patients With Autogenous Arteriovenous Fistula And Its Correlation With Failure

Objective:The purpose of this study is to investigate the current status of debilitation in patients with autologous arteriovenous fistula and its correlation with failure.Methods:This study collected 163 patients treated with autologous arteriovenous fistula(AVF)for long-term regular maintenance hemodialysis(MHD)treatment in The First Affiliated Hospital of Gannan Medical University from September 2021 to October2022.Grouped according to whether the patient is failure,divided into failure group(observation group)and patency group(control group).Frailty Phenotype(FP)was used to assess frailty.Chi-square test was used to analyze the correlation between frailty and AVF dysfunction,and univariate and multivariate Logistic regression were used to analyze the independent risk factors for AVF failure.Receiver operating characteristic(ROC)curve was drawn according to the prediction probability of logistic analysis results,and the independent risk factors wereestablished as nomograms prediction model.Results:1.The incidence of frailty was 49.4%in the dysfunction group and 30.3%in the patency group.Chi-square test was used for comparison.Frailty(Χ2=6.740,P=0.034),low grip strength(Χ2=9.633,P=0.002),fatigue(Χ2=13.323,P<0.001),diabetes(Χ2=57.256,P<0.001)and hypertension(Χ2=12.088,P=0.001)were more common in failure group than in the patencygroup,the difference was statistically significant(P<0.05).2.In univariate analysis,there were statistically significant differences in dialysis age,AVF use time,potassium(K),uric-acid(UA),mid-arm circumference(MAC)and mid-arm muscle circumference(MAMC),between the failuregroup andthe patency group(P<0.05).3.Logistic multivariate analysis showed that poor grip strength(OR=3.600,95%CI:1.144-11.325,P=0.028),fatigue(OR=7.251,95%CI:1.857-28.316,P=0.004),diabetes(OR=15.395,95%CI:5.922-40.025,P<0.001),hypertension(OR=3.48,95%CI:1.301-9.311,P=0.013)were independent riskfactors for failure.4.The area under the ROC curve was 0.877(95%CI:0.823-0.931).According to the independent risk factors,a nomogram was drawn to predict the risk of AVF failure in maintenance hemodialysis patients,and Hosmer-Lemeshow chi-square test was used.(Χ~2=2.779);P=0.947(P>0.05).The results showed that the model had good prediction efficiency.Conclusion:1.In 163 patients undergoing maintenance hemodialysis with AVF,the incidence of frailty was higher inthe AVF failuregroup than inthe AVF patency group;2.Frailty,poor grip strength,fatigue,diabetes and hypertension were positively correlated with AVF failure.3.Poor grip strength,fatigue,diabetes,and hypertension were independent risk factors for AVFfailure;4.The combined prediction model of poor grip strength,fatigue,diabetes and hypertension has high accuracy inpredicting AVF failure.