Author/Editor		Gasparini, Mladen; Popovič, Dražen; Kovačič, Morena
Title		Dejavniki, ki vplivajo na zaporo arteriovenske fistule za hemodializo
Translated title		Factors affecting the patency of arteriovenous fistulas for haemodialysis
Type		članek
Source		Med Razgl
Vol. and No.		Letnik 42, št. Suppl 2
Publication year		2003
Volume		str. 141-7
Language		slo
Abstract		Native arteriovenous fistula (AVF) is the vascular access of choice for hemodialysis in patients with end-stage renal disease. Over 30 factors have been described in literature that can affect AVF maturation and patency. A retrospective analysis was performed of surgical and dialysis protocols for 78 patients who were operated on for wrist AVF between January 1996 and December 2000 at the vascular departments of two general hospitals in Slovenia. Data on their age, sex, diabetes mellitus, previous vascular access and patency were collected. Secondary AVF patency after 2-years was 60%. Based on univariate analysis it was concluded that patients older than 65 years and diabetic patients have significantly lower 2-year AVF patency rates (p = 0.05 and p = 0.02, respectively). Women and patients who were already on hemodialysis before surgery for AVF construction did not show any statistically significant differences. Vascular mapping by preoperative ultrasound and postoperative duplex follow-up may improve long-term AVF patency.
Summary		Arteriovenska fistula (AVF) je priporočeni žilni pristop za hemodializo pri bolnikih s končno odpovedjo ledvic. V literaturi je opisanih preko 30 dejavnikov, ki lahko vplivajo na njeno zorenje in prehodnost. Retrospektivno smo pregledali operacijske in dializne protokole za 78 bolnikov, ki so imeli prvič narejeno AVF na zapestju med letoma 1996 in 2000 na žilnih oddelkih Splošne bolnišnice Izola in Splošne bolnišnice Murska Sobota. Zasledovali smo podatke o starosti, spolu, sladkorni bolezni, predhodni dializi in prehodnosti žilnega pristopa. Dveletna sekundarna prehodnost je znašala 60%. Z univariatno analizo smo ugotovili statistično pomembno znižano prehodnost AVF po dveh letih pri bolnikih, starejših od 65 let (p = 0,05), in pri bolnikih s sladkorno boleznijo (p = 0,02). Pri ženskah in bolnikih, ki so se ob operaciji že dializirali, razlike niso bile statistično značilne. Predoperacijska ultrazvočna preiskava in pooperacijski nadzor z dvojnim barvnim doplerjem lahko izboljšata dolgoročno prehodnost žilnih pristopov.
Descriptors		HEMODIALYSIS ARTERIOVENOUS SHUNT, SURGICAL CATHETERIZATION, PERIPHERAL VASCULAR PATENCY DIABETES MELLITUS THROMBOSIS