Arteriovenöz fistül oluşturulmasında yeni endotelyal hasar inhibitörü kullanılmasının etki ve güvenirliği

Öz

Amaç: Son dönem böbrek hastalığı olan hastalar, hemodiyaliz için doğru ve etkili damar erişimine ihtiyaç duymaktadır. Böbrek nakli, hemodiyaliz gereksinimi olmadan yaşamın sürdürülmesini sağlayan kesin tedavi yöntemi olsa da, yetersiz böbrek donörü nedeniyle uzun süreli hemodiyalizin sürdürülmesinde en sık kullanılan yöntem arteriyovenöz (AV) fistüldür. Bu çalışmada, endotel koruma solüsyonu ile veya solüsyonsuz oluşturulan AV fistülün açıklık oranlarını karşılaştırmayı amaçladık. Yöntemler: Bu tek merkezli vaka control çalışması Ağustos 2018 ile Ağustos 2019 arasında gerçekleştirilmiştir. Hemodiyaliz için son dönem böbrek hastalığı olan hastalar (toplam 49 hasta) çalışmaya dahil edilmiştir. Hastalar grup A (endotel koruma solüsyonu ile oluşturulan AV fistüller çalışma grubu olarak, n=27) ve grup B (endotel koruma solüsyonu olmadan oluşturulan AV fistüller control grubu olarak, n=22) olarak iki gruba ayrıldı. Tüm fistül anastomozları aynı cerrahi ekip tarafından yapıldı. 3. ve 6. aydaki demografik veriler, olgunlaşma süresi, ortalama akış hacmi, komplikasyonlar, bazal metabolizma indeksi (VKİ) ve açıklık oranları karşılaştırıldı. Bulgular: Demografik bulgular açısından iki grup arasında fark yoktu (P>0,05). Grup A'da 3. ve 6. ayda (%96 ve %93) B grubuna (%64 ve %27) göre daha yüksek açıklık oranları saptandı (P<0,05). Sonuç: Endotelyal koruma solüsyonu ile oluşturulan AV fistül, geleneksel AV fistül oluşturma ile karşılaştırıldığında daha yüksek açıklık oranlarına sahip gibi görünmektedir.

Anahtar Kelimeler

• Son dönem böbrek hastalığı
• Arteryo-venöz fistüller
• Endotelyal koruma solüsyonu
• Açıklık oranı

Effectiveness and safety of using a novel endothelial damage inhibitor in arteriovenous fistula formation

Abstract

Aim: Patients with end-stage renal disease need accurate and effective vascular access for hemodialysis. Although renal transplantation is the golden standard treatment that provides a life without hemodialysis, an arteriovenous (AV) fistula is the most frequent method for sustaining long-term hemodialysis because of insufficient renal donors. In the current study, we aimed to compare patency rates of AV fistulae created with or without the endothelial protection solution. Methods: This single-center case-control study was conducted between August 2018 and August 2019. Patients with end-stage renal disease requiring AV fistula access for hemodialysis (n= 49) were included in the study and divided into two groups. During the creation of an AV fistulae, endothelial protection solution was used in 27 patients, who constituted Group A, and not used in 22 patients, who were included in Group B (the control group). All fistulae anastomoses were performed by the same surgical team. The demographical data, maturation time, mean flow volume, complications, basal metabolism index (BMI), and patency rates at the 3rd and 6th months were compared. Results: There was no significant difference between the two groups regarding demographical findings (p>0.05). The patency rates were higher in group A at both the 3rd and 6th months (96% and 93%) when compared with group B (64% and 27%) (P<0.05). Conclusion: AV fistulae created with endothelial protection solution has higher patency rates compared to conventionally created AV fistulae.

Keywords

• End stage renal disease
• Arteriovenous fistula
• Endothelial protection solution
• Patency rate

Kaynakça

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