终末期肾病患者桡动脉头静脉内瘘初级通畅率影响因素的回顾性队列研究

doi:10.3969/j.issn.1006-298X.2023.01.003

肾脏病与透析肾移植杂志 ›› 2023, Vol. 32 ›› Issue (1): 15-20.DOI: 10.3969/j.issn.1006-298X.2023.01.003

终末期肾病患者桡动脉头静脉内瘘初级通畅率影响因素的回顾性队列研究

出版日期:2023-02-28 发布日期:2023-02-23

Primary patency of radiocephalic fistulas in patients with end stage kidney disease: a retrospective cohort study

Online:2023-02-28 Published:2023-02-23

摘要/Abstract

摘要： 目的：通过回顾性队列研究探讨终末期肾病患者桡动脉头静脉内瘘(RCF)建立后初级通畅率影响因素。
方法：从2016年1月至2019年6月在山东第一医科大学第一附属医院肾病学科诊断为慢性肾脏病（CKD）4～5期且初次行RCF的276例患者建立回顾性队列,随访时间截止于2021年11月,中位随访时间40月。收集入组患者年龄、性别、用药史、生化指标等临床资料,应用KaplanMeier生存曲线计算RCF的通畅率。RCF失功定义为血管狭窄(血管直径狭窄≥50％)或血栓形成不能提供充足的血流量完成透析治疗。COX多因素回归分析探讨影响RCF失功的因素。
结果：患者平均年龄为517±146岁,609％为男性。在CKD的病因中慢性肾小球肾炎占446％,糖尿病肾脏疾病占311％。在整个随访过程中,68例(246％)患者发生RCF的失功。KaplanMeier生存曲线分析显示,RCF建立后第12个月、24个月、36个月、48个月、60个月的初级通畅率分别为895％、830％、783％、757％和757％。COX多因素模型分析显示,年龄(≥65岁)为RCF失功的危险因素(HR=283, 95％CI 130～619);校正钙(每增加1 mg／dL)为RCF失功的保护因素(HR=066, 95％CI 047～094);而性别、糖尿病、高血压、血脂、血磷、甲状旁腺激素等与RCF的失功不相关。
结论：终末期肾病患者RCF建立后初级通畅率在12月和24月分别为895％, 830％。随着时间的推进,其通畅率开始缓慢下降,年龄与校正钙水平与RCF的失功密切相关。

关键词: 终末期肾病, 桡动脉-头静脉内瘘, 初级通畅率, 回顾性队列研究

Abstract: Ｏｂｊｅｃｔｉｖｅ：A retrospective cohort study was conducted to explore influencing factors of primary patency rate of radiocephalic fistula (RCF) in patients with end stage kidney disease.
Ｍｅｔｈｏｄｏｌｏｇｙ：276 patients with chronic kidney disease (CKD) stage 45 who underwent RCF creation for the first time in our hospital from January 2016 to June 2019 were enrolled. The followup time ended in November 2021, with a median followup of 40 months. Clinical data and biochemical parameters were collected. KaplanMeier survival curve was used to calculate the patency rate of RCF. RCF failure was defined as vascular stenosis (vessel diameter stenosis≥50％) or thrombosis, which could not provide sufficient blood flow to complete dialysis treatment. Multivariate Cox regression analysis was used to explore the related factors of RCF failure.
Ｒｅｓｕｌｔｓ：The mean age of the patients was 517±146 years, and 609％ were male. Chronic glomerulonephritis accounted for 446％ of CKD and diabetic nephropathy accounted for 311％. During followup, 68 (246％) patients developed fistula failure. KaplanMeier survival curve analysis showed that the primary patency rates at 12, 24, 36, 48 and 60 months after establishment of RCF were 895％, 830％, 783％, 757％ and 757％, respectively. Multivariate COX model analysis showed that age (≥65 years) was a risk factor for RCF failure, with HR value of 283 and 95％CI of 130~619. Adjusted calcium (per increase of 1mg／dL) was a protective factor for the RCF failure, with HR value of 066 and 95％CI of 047~094. However, gender, diabetes mellitus, hypertension, blood lipids, blood phosphorus and parathyroid hormone were not associated with RCF failure.
Ｃｏｎｃｌｕｓｉｏｎ：In this study, it was found that the primary patency rates of RCF creation were 895％ and 830％ at 12 and 24 months, respectively. The patency rate began to decline slowly over time. Age and corrected calcium level were significantly related to RCF failure.

Key words: end stage kidney disease, radio-cephalic fistula, primary patency, retrospective cohort study

许姝琦, 唐利军, 曹维, 梁黎明, 王尊松, 孔祥雷. 终末期肾病患者桡动脉头静脉内瘘初级通畅率影响因素的回顾性队列研究[J]. 肾脏病与透析肾移植杂志, 2023, 32(1): 15-20.

XU Shuqi, TANG Lijun, CAO Wei, LIANG Liming, WANG Zunsong, KONG Xianglei. Primary patency of radiocephalic fistulas in patients with end stage kidney disease: a retrospective cohort study[J]. Chinese Journal of Nephrology, Dialysis & Transplantation, 2023, 32(1): 15-20.

ISSN 1006-298X CN 32-1425/R

终末期肾病患者桡动脉头静脉内瘘初级通畅率影响因素的回顾性队列研究

Primary patency of radiocephalic fistulas in patients with end stage kidney disease: a retrospective cohort study

PDF

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 0

编辑推荐

Metrics

本文评价