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KMID : 0376419960200010067
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Chonbuk University Medical Journal
1996 Volume.20 No. 1 p.67 ~ p.78
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A clinical Analysis on the Factors Influencing the Patent sof Internal Arteriovenous Fistula in Patients with Chronic Renal Failure
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이제경
이홍범/고현우/이병철/박성광/강성귀/이승렬
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Abstract
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To obtain vascular access for hemodialysis, and to keep these vessels patent for a long time, is essential for patients of chronic renal failure. Since 1966 Brescia and Cimino introduced the use of subcutaneous arteriovenous(A-V) fistula as the
vascular
access for long time hemodialysis, internal A-V fistula has been used widely today. The factors influencing the early patency of internal A-V fistula in chronic renal failure were examined in several centers, but the studies for
erythropoietin(EPO)
influencing the function of A-V fistula were rarely studied.
Therefore authors were reviewed the 143 cases of A-V fistula created at Chonbuk National University Hospital from June, 1988 to June, 1994. Authros were examined whether the following factors including age & sex, underlying disease, fistula sites
&
types, initial postoperative A-V fistula state, first time of puncture, blood pressure, diabetes mellitus, and EPO had influence on the early & late patency of A-V fistula.
@ES The following results were obtained:
@EN 1) The factors related to the early failure were diabets mellitus and poor condition of initial postoperative fistula state.
2) The factor influencing late patency was poor condition of initial postoperative state.
3) The EPO therapy increases hematocrit level but does not seem to affect fistula function.
4) Average 1-, 2-. 3-year patency rates of A-V fistula in total population were 86.0%, 81.8%, 76.2%, respectively, and the mean period of overall patency was 34.4 months.
5) The complications of A-V fistula were thrombosis, local infection, vessel stenosis or others.
6) The main cause of thrombosis was poor technical care after repeated venopuncture for hemodialysis.
7) Age & sex, fistula sites & types, first time of puncture, blood pressure, EPO were not correlated with A-V fistula patency.
A-V fistula patency rate was significantly lower in diabetic patients and poor condition of initial postoperative A-V fistula state. Therefore we should manage A-V fistula more carefully to prevent thrombosis in end stage renal disease patients
with
hemodialysis, especially diabetics, and recommand the adequate EPO therapy in selective cases.
In future, it may be necessary to determine the major factors for the patency of A-V fistula.
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KEYWORD
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