Impact of arteriovenous fistula blood flow on serum il-6, cardiovascular events and death: An ambispective cohort analysis of 64 Chinese hemodialysis patientsReport as inadecuate




Impact of arteriovenous fistula blood flow on serum il-6, cardiovascular events and death: An ambispective cohort analysis of 64 Chinese hemodialysis patients - Download this document for free, or read online. Document in PDF available to download.

Flows Qa of arteriovenous fistula AVF impact the dialysis adequacy in hemodialysis HD patients. However, data for different access flow levels on outcomes related to long-term dialysis patients, especially in Chinese patients, are limited. Herein, we performed an ambispective, mono-centric cohort study investigating the association between the AVF flows and inflammation, cardiovascular events and deaths in Chinese hemodialysis patients bearing a radio-cephalic fistula AVF from 2009 to 2015. Twenty-three patients 35.9% developed at least one episode of cardiovascular disease CVD in two years after AVF creation. AVF Qa, IL-6 and hsCRP were significantly higher in patients with CVD than in patients without CVD. Multi-factorial binary logistic regression analysis found that the independent and strongest risk factor for CVD in HD patients was serum IL-6, which showed a positive association with AVF Qa levels in patients. Therefore, the linkage between AVF Qa tertiles and adverse clinical outcomes cardiovascular events and mortality was examined over a median follow-up of five years. IL-6 was significantly increased in the high AVF Qa >1027.13 ml-min group. Patients with median AVF Qa showed the lowest morbidity and mortality of CVD according to the AVF Qa tertiles, whereas higher Qa was associated with a higher risk of CVD, and lower AVF Qa 600 ml-min ≤AVF Qa <821.12 ml-min had a higher risk of non-CVD death. Therefore, keeping the AVF Qa at an optimal level 821.12 to 1027.13 ml-min would benefit HD patients, improve long-term clinical outcomes and lower AVF-induced inflammation.



Author: Zhizhi Hu , Fengmin Zhu , Nan Zhang, Chunxiu Zhang, Guangchang Pei, Pengge Wang, Juan Yang, Yujiao Guo, Meng Wang, Yuxi Wang, Qia

Source: http://plos.srce.hr/



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