Author/Editor     Vajdic, B; Arnol, M; Ponikvar, R; Kandus, A; Buturović-Ponikvar, J
Title     Functional status of hemodialysis arteriovenous fistula in kidney transplant recipients as a predictor of allograft function and survival
Type     članek
Source     Transplant Proc
Vol. and No.     Letnik 42, št. 10
Publication year     2010
Volume     str. 4006-9
Language     eng
Abstract     There is no accepted policy for preserving or ligating arteriovenous fistula (AVF) after successful kidney transplantation. The aim of this study was to compare kidney graft function and survival between patients with a functional AVF at 1 year after-transplantation with those having a nonfunctional AVF. This historical cohort study included 311 kidney transplant recipients between January 2000 and December 2008 with a functional AVF at the time of transplantation. Patients were divided into 2 groups according to functional status of AVF at 1 year after transplantation. Graft function was assessed at 1 year by serum creatinine and estimated glomerular filtration rate (eGFR) using the 4-variable Modification of Diet in Renal Disease formula. Kaplan-Meier and Cox proportional hazards analyses were used to assess the relationship between the functional status of the AVF and graft survival. The 311 recipients had a mean age of 47 +/- 11 years (range, 14 to 70) with 188 (60.5%) males. Patients with functional AVF at 1 year (n = 239) showed higher serum creatinine and lower eGFR values than those with nonfunctional AVF (n = 72): namely 110 +/- 38 mumol/L and 69 +/- 21 mL/min/1.73 m(2) versus 99 +/- 30 mumol/L and 74 +/- 19 mL/min/1.73 m(2), respectively (P < .05). Persistence of a functional AVF at 1 year after transplantation was associated with a greater incidence of eGFR <60 mL/min/1.73 m(2) compared with nonfunctional AVF: 36.8% versus 23.6% (odds ratio, 1.885; 95% confidence interval [CI], 1.031-3.450; P = .038). The 5-year allograft survival rates were 60% among patients with a functional AVF versus 75% among those with a nonfunctional AVF (P = .045). The adjusted analyses revealed the persistence of a functional AVF to be associated with an increased risk for future allograft loss (hazard ratio, 1.336; 95% CI, 1.018-1.755; P = .037). (Abs. trunc. at 2000 ch.)
Descriptors     KIDNEY TRANSPLANTATION
GRAFT SURVIVAL
ARTERIOVENOUS SHUNT, SURGICAL
HEMODIALYSIS
CATHETERS, INDWELLING
CREATININE
GLOMERULAR FILTRATION RATE
PROPORTIONAL HAZARDS MODELS