Santral venöz katateri olan hastalarda radyosefalik arteriyovenöz fistül matürasyonunu için prognostik faktörler ve inflamasyonla ilişkisi

Yıl 2020, , 124 - 132, 22.06.2020

Ali Baran Budak Tonguc Saba Nalan Akalın Gultekin Genctoy Cevahir Haberal

https://doi.org/10.18663/tjcl.739377

Öz

Amaç:Matüre ve fonksiyonel bir arteriovenöz fistül (AVF), hemodiyaliz (HD) tedavisi tedavisinde vasküler erişim için en iyi modalite olarak kabul edilir; ancak erken başarısızlık oranı HD tedavisine santral venöz kateter (SVK) ile başlayan hastalarda yüksektir. Bu çalışmanın amacı, HD tedavilerine SVK ile başlayan ve daha sonra ilk kez radiosefalik AVF (RSAVF) oluşturulan hastalarda belirli hasta özelliklerinin ve spesifik inflamatuar belirteçlerin AVF’nin erken başarısızlığı açısından prognostik değeri ve ilişkisini incelemekti.
Gereç ve Yöntemler: Aynı cerrah tarafından, aynı teknik kullanılarak RSAVF oluşturulan ve konsülte edildiği sırada HD tedavisi için damar erişimi SVK ile önceden sağlanmış son-dönem böbrek hastalığı bulunan 168 hasta retrospektif olarak tarandı. Bu çalışmaya alınan hastalar Grup 1: erken başarısızlık olan (n=46) ve Grup 2: erken başarısızlık olmayan (n=122) olarak iki gruba ayrıldı. Bu hastaların, demografik özellikleri, yandaş hastalıkları, preoperatif doppler ultrasomografi haritalama sonuçları, laboratuar parametreleri, postoperatif takip detayları toplandı. Tüm hastaların primer patens oranları, erken başarısızlık oranı, maturasyon başarısızlık oranı ve SVK süreleri hesaplandı.
Bulgular: Kadın cinsiyet RSAVF erken başarısızlığında anlamlı bir risk faktörü olarak bulunmuştur (%69.5 vs %36.1; p=0.001). Sefalik ven çapı< 2 mm olan hastaların sayısı Grup 1’de fazlaydı (%78.3 vs %22.1 ; p=0.028). Grup 1’de SVK erişim süresi Grup 2’den anlamlı olarak daha uzundu (6.8 ± 3.6 ay vs 2.3 ± 1.7 ay; p<0.05). Maturasyon yetersizlik oranı %12.5 ve 1-yıllık primer patensoranı%72.6 idi.Grup 2’de, Grup 1’e oranla 1.yılda C-Reaktif Proteindüzeyleri (7.2 ± 9.6 vs 3.1 ± 3.3 mg/L, respectively; p=0.001) ve nötrofil lenfosit oranı(2.91± 0.30 vs 2.17 ± 0.22, respectively; p<0.05) anlamlı derecede düşüktü.
Sonuç: Önceden HD tedavisi için damar erişimi SVK ile sağlanan hastalarda, küçük sefalik ven çapı, kadın cinsiyet ve sistemik inflamasyon, ilk defa açılan RSAVF’ün erken başarısızlığında rol oynayabilir.

Anahtar Kelimeler

otojen radyosefalik arteriovenöz fistül, erken başarısızlık, sefalik ven, inflamasyon

Prognostic factors for radiocephalic arteriovenous fistula maturation in patients with prior placement of a central venous catheter and relationship with inflammation

Öz

Aim: A mature and functional arteriovenous fistula (AVF) is considered the best modality for vascular access(VA) for hemodialysis (HD) treatment but the incidence of early failure is high, especially in patients start their HD with a central venous catheter. The aim of this study was to evaluate the prognostic value and association of certain patient characteristics and specific inflammatory markers with early failure of AVF in patients who started their HD therapy with a CVC and a first autogenous radiocephalic AVF (RCAVF) was created after vascular consultation.
Material and Methods: A retrospective review of 168 patients with end-stage renal disease who underwent RCAVF creation by the same surgeon by using the same surgical technique and whose primary vascular access for HD treatment was obtained via CVC at the time of access consultation was performed. The patients enrolled into this study were categorized into two groups as Group 1: patients with early failure (n=46) and Group 2: patients with no failure (n=122).Demographic characteristics, medical comorbidities, preoperative doppler ultrasound mapping results, laboratory parameters, postoperative follow-up details of these patients were collected. Primary patency of all patients, early failure rate, maturation failure rate, duration of CVC was calculated.
Results: Female gender was found to be a significant risk factor in early failure of RCAVF (69.5% vs 36.1%; p=0.001). The number of patients whose diameter of cephalic vein< 2 mm were significantly higher in EF group (78.3% vs 22.1 ; p=0.028). The duration of CVC access of group 1 was significantly longer than group 2 (6.8 ± 3.6 months vs 2.3 ± 1.7 months, respectively; p<0.05). Overall maturation failure rate was 12.5% and primary patency at 1 year was 72.6%. Levels of C-Reactive protein (7.2 ± 9.6 vs 3.1 ± 3.3 mg/L, respectively; p=0.001) and neutrophil lymphocyte ratio (2.91± 0.30 vs 2.17 ± 0.22, respectively; p<0.05) was significantly lower at group 2 at one year.
Conclusion:In patients whose VA for HD treatment was provided by CVC, small cephalic vein diameter, female gender and systemic inflammation may play a role in early failure of RCAVF.

Anahtar Kelimeler

autogenous radiocephalic arteriovenous fistula, early failure, cephalic vein, inflammation

Kaynakça

• 1. Fila B, Ibeas J, Tey RR, et al. Arteriovenous fistula for hae- modialysis: the role of surgical experience and vascular ac- cess education. Nefrologia 2016; 36: 89-94.
• 2. Takemoto Y, Naganuma T. Economic issues of chronic kidney disease and end-stage renal disease. Contrib Nephrol 2019; 198: 87-93.
• 3. Bashar K, Healy D, Browne LD, Kheirelseid EA, Walsh MT, Moloney MC, et al. Role of far infrared therapy in dialysis arterio-venous fistula maturation and survival: systematic review and meta-analysis. PLoS One. (2014); 9: e104931.
• 4. Chand DH, Valentini RP, Kamil ES. Hemodialysis vascular access options in pediatrics: considerations for patients and practitioners. Pediatr Nephrol. (2009); 24: 1121–1128.
• 5. Santoro A, Canova C, Freyrie A, Mancini E. Vascular access for hemodialysis. J Nephrol. (2006); 19: 259–264.
• 6. Schmidli J, Widmer MK, Basile C, Donato G, Gallieni M, et al. Editor's Choice - Vascular Access: 2018 Clinical Practice Guidelines of the European Society for Vascular Surgery (ESVS). Eur J Vasc Endovasc Surg 2018 Jun;55(6):757-818.
• 7. Feldman HI, Kobrin S, Wasserstein A. Hemodialysis vascular access morbidity. J Am Soc Nephrol 1996;7:523-35.
• 8. National Kidney Foundation-Dialysis Outcomes Quality Initiative. National Kidney Foundation. NKF-DOQI clinical practice guidelines for vascular access. Am J Kidney Dis 1997;30(suppl):S150-91.
• 9. Miller PE, Tolwani A, Luscy CP, Deierhoi MH, Bailey R, Redden DT, et al. Predictors of adequacy of arteriovenous fistulas in hemodialysis patients. Kidney Int 1999;56:275e80.
• 10. R.L.Pisoni, E.W.Young, D.M.Dykstra, etal.,Vascular access use in Europe and the United States: results from the DOPPS, Kidney Int. 61 (1) (2002) 305–316.
• 11. A.J. Collins, R.N. Foley, D.T. Gilbertson, S.C. Chen, The state of chronic kidney disease, ESRD, and morbidity and mortality in the first year of dialysis, Clin. J. Am. Soc. Nephrol. 4 (Suppl 1) (2009) S5–S11.
• 12. Lauvao LS, Ihnat DM, Goshima KR, Chavez L, Gruessner AC, Mills Sr JL. Vein diameter is the major predictor of fistula maturation. J Vasc Surg 2009; 49 (6) :1499-504.
• 13. Maya ID, O’Neal JC, Young CJ, Barker-Finkel J, Allon M. Outcomes of brachiocephalic fistulas, transposed brachiobasilic fistulas, and upper arm grafts. Clin J Am Soc Nephrol 2009;4(1): 86e92.
• 14. Dageforde LA, Harms KA, Feurer ID, et al. Increased mini- mum vein diameter on preoperative mapping with duplex ultrasound is associated with arteriovenous fistula maturation and secondary patency. J Vasc Surg 2015;61:170-6.
• 15. Robbin ML, Chamberlain NE, Lockhart ME, et al. Hemodial- ysis arteriovenous fistula maturity: US evaluation. Radiology 2002; 225: 59-64.
• 16. National Kidney Foundation’s KDOQI 2006 Vascular Access Guidelines. Am J Kidney Dis 2006;48: S177-322.
• 17. Sidawy AN, Spergel LM, Besarab A, Allon M, Jennings WC, Padberg Jr FT, et al. The Society for Vascular Surgery: clinical practice guidelines for the surgical placement and maintenance of arteriovenous hemodialysis access. J Vasc Surg 2008; 48:2Se 25S.
• 18. Wong CS, McNicholas N, Healy D, Clarke-Moloney M, Coffey JC, Grace PA, Walsh SR. A systematic review of preoperative duplex ultrasonography and arteriovenous fistula formation. J Vasc Surg 2013; 57:1129e33.
• 19. A. Brahmbhatt, A. Remuzzi, M. Franzoni, S. Misra, The molecular mechanisms of hemodialysis vascular access failure, Kidney Int. 89 (2) (2016) 303–316.
• 20. H. Hu, S. Patel, J.J. Hanisch, et al., Future research directions to improve fistula maturation and reduce access failure, Semin. Vasc. Surg. 29 (4) (2016) 153–171.
• 21. M.A. Kaygin, U. Halici, A. Aydin, et al., The relationship between arteriovenous fistula success and inflammation, Ren, Fail 35 (8) (2013) 1085–1088.
• 22. Chou CY, Kuo HL, Yung YF, Liu YL, Huang CC. C-reactive Protein Predicts Vascular Access Thrombosis in Hemodialysis Patients. Blood Purif 2006;24(4):342-6.
• 23. de Graaf R, Dammers R, Vainas T, Hoeks AP, Tordoir JH. Detection of cell-cycle regulators in failed arteriovenous fistulas for hemodialysis. Nephrol Dial Transplant. 2003;18:814-818.
• 24. Muhammed Suliman MA, Bahnacy Juma AA, Ali Almadhani AA, Pathare AV, Alkindi SS, Uwe Werner F. Predictive value of neutrophil to lymphocyte ratio in outcomes of patients with acute coronary syndrome. Arch Med Res. 2010;41(8):618–622.
• 25. Yilmaz H, Alper Bozkurt A, Cakmak M, Celik HT, et al. Relationship Between Late Arteriovenous Fistula (AVF) Stenosis and Neutrophil-Lymphocyte Ratio (NLR) in Chronic Hemodialysis Patients. Ren Fail 2014 Oct;36(9):1390-4.
• 26. Bashar K, Zafar A , Ahmed K, Kheirelseid EAH, Healy D et al. Can a Neutrophil-Lymphocyte Ratio Derived From Preoperative Blood Tests Predict Arteriovenous Fistula Maturation? Ann Vasc Surg 2016 Aug;35:60-7.
• 27. Dukkipati JR, Molnar MZ, Park J ,etal., Association of vascular access type with inflammatory marker levels in maintenance hemodialysis patients, Semin. Dial. 27 (4) (2014) 415–423.
• 28. Wongmahisorn Y. Maturation of arteriovenous fistulas in patients with and without preexisting hemodialysis catheters. Annals of Medicine and Surgery 2019;48:11-16.
• 29. Sachdeva M, Kovalchuk O, Bitzer M, Mokrzycki MH. Vascular access type and changes in inflammatory markers in incident dialysis patients: a pilot study. J Vasc Access. 2009;10:174-179.
• 30. Coli L, Donati G, Cappucilli ML, et al. Role of the he- modialysis vascular access type in inflammation status and monocyte activation. Int J Artif Organs. 2011;34:481-488.
• 31. McGrogan DG, Maxwell AP, Khawaja AZ, Inston NG. Current tools for prediction of arteriovenous fistula outcomes. Clin Kidney J 2015;8:282e9.
• 32. Davidson I, Chan D, Dolmatch B, et al. Duplex Ultrasound evaluation for dialysis access selection and maintenance: a practical guide. J Vasc Access 2008;9(1):1-9.
• 33. Malovrh M. Native arteriovenous fistula: preoperative evalua- tion. Am J Kidney Dis. 2002;39(6):1218-1225.
• 34. Pajek J, Malovrth M. Preoperative ultrasound still valuable for radio-cephalic arteriovenous fistula creation? J Vasc Access 2017; 18 (Suppl 1): S5-S9
• 35. Brimble KS, Rabbat ChG, Treleaven DJ, Ingram AJ. Utility of ul- trasonographic venous assessment prior to forearm arteriove- nous fistula creation. Clin Nephrol. 2002;58(2):122-127.
• 36. Mendes RR, Farber MA, Marston WA, Dinwiddie LC, Keagy BA, Burnham SJ. Prediction of wrist arteriovenous fistula matura- tion with preoperative vein mapping with ultrasonography. J Vasc Surg. 2002;36(3):460-463.
• 37. Kordzadeh A, Chung J, Panayiotopoulos YP. Cephalic vein and radial artery diameter in formation of radiocephalic arterio- venous fistula: a systematic review. J Vasc Access. 2015;16(6): 506-511.
• 38. Silva MB Jr, Hobson RWII, Pappas PJ, et al. A strategy for in- creasing use of autogenous hemodialysis access procedures: impact of preoperative noninvasive evaluation. J Vasc Surg. 1998;27(2):302-307.
• 39. Sidawy AN, Gray R, Besarab A, Henry M, Ascher E, et al. Recommended standards for reports dealing with arteriovenous hemodialysis accesses. J Vasc Surg 2002;35(3):603e10.
• 40. Barreto P, Almeida P, Matos N, Queirós JA, J Pinheiro J et al. Preoperative Vessel Mapping in Chronic Kidney Disease Patients - A Center Experience. J Vasc Access 2016 Jul 12;17(4):320-7.
• 41. Malovrh M. The role of sonography in the planning of arteriovenous fistulas for hemodialysis. Semin Dial. 2003; 16:299- 303.
• 42. Cook KM, Padberg Jr FT. Is There an Accurate Pre-operative Criterion for Dialysis Access Artery or Vein Diameter? Eur J Vasc Endovasc Surg 2017 Jun;53(6):879.
• 43. Allon M, Robbin ML. Increasing arteriovenous fistulas in hemodialysis patients: problems and solutions. Kidney Int 2002; 62:1109-24.
• 44. Bashar K, Zafar A, Elsheikh S, Healy DA, Clarke-Moloney M, Casserly L, Burke PE, Kavanagh EG, Walsh SR. Predictive Parameters of Arteriovenous Fistula Functional Maturation in a Population of Patients with End-Stage Renal Disease. PLoS One. 2015; 10(3):e0119958.
• 45. Al-Jaishi AA, Oliver M, Thomas SM et al. Patency rates of the arteriovenous fistula for hemodialysis: a systematic review and meta-analysis. Am J Kidney Dis 2014; 63:464-78.
• 46. Peterson WJ, Barker J, Allon M. Disparities in fistula maturation persist despite preoperative vascular mapping. Clin J Am Soc Nephrol 2008; 3:437-41.
• 47. Miller CD, Robbin ML, Allon M. Gender differences in outcomes of arteriovenous fistulas in hemodialysis patients. Kidney Int 2003; 63:346-52.
• 48. Wasse H, Hopson DS, McClellan W. Racial and Gender Differences in Arteriovenous Fistula Use among Incident Hemodialysis Patients. Am J Nephrol. 2010; 32(3):234-241.
• 49. Lee T, Thamer M, Zhang Q, et al. Vascular access type and clinical outcomes among elderly patients on hemodialysis. Clin J Am Soc Nephrol 2017; 12: 1823-30.
• 50. Richardson AI 2nd, Leake A, Schmieder GC, et al. Should fistulas really be first in the elderly patient? J Vasc Access 2009; 10: 199-202.
• 51. Lok CE, Oliver MJ, Su J, et al. Arteriovenous fistula out- comes in the era of the elderly dialysis population. Kidney Int 2005; 67: 2462-9.
• 52. Schinstock CA, Albright RC, Williams AW, et al. Outcomes of arteriovenous fistula creation after the Fistula First Initiative. Clin J Am Soc Nephrol 2011; 6: 1996-2002.
• 53. Polenakovic M, Sikole A, Nikolov IG, Georgiev D, Selim G, et al. Diabetics on dialysis in the Republic of Macedonia: A nationwide epidemiological study. Prilozi. 2010; 31(1):261-77.
• 54. Gjorgjievski N, Vidimliski PD, Gerasimovska V, Kuzmanovska SP et al. Primary Failure of the Arteriovenous Fistula in Patients With Chronic Kidney Disease Stage 4/5. Open Access Maced J Med Sci 2019 Jun 15;7(11):1782-1787.
• 55. Wongmahisorn Y. Survival and Prognostic Predictors of Primary Arteriovenous Fistula for Hemodialysis. Ann Vasc Dis 2019 Dec 25;12(4):493-499.
• 56. Paneni F, Beckman JA, Creager MA, et al. Diabetes and vas- cular disease: pathophysiology, clinical consequences, and medical therapy: part I. Eur Heart J 2013; 34: 2436-43.
• 57. Liabeuf S, Olivier B, Vemeer C, et al. Vascular calcification in patients with type 2 diabetes: the involvement of matrix Gla protein. Cardiovasc Diabetol 2014; 13: 85.
• 58. Wells AC, Fernando, Butler A, Huguet E, Bardley JA, Pettigrew GJ. Selective use of ultrasonographic vascular mapping in the assessment of patients before hemodialysis access surgery. Br J Surg 2005; 92:1439-43.
• 59. Nursal TZ, Oguzkurt L, Tercan F et al. Is routine preoperative ultrasonographic mapping for arteriovenous fistula creation necessary in patients with favourable physical examination findings? Results of a randomized controlled trial. World J Surg 2006; 30:1100-07.
• 60. Smith GE, Barnes R, Chetter IC. Randomized clinical trial of selective versus routine preoperative duplex ultrasound imaging before arteriovenous fistula surger. Br J Surg 2014; 101:469-74.
• 61. Hossain S, Sharma A, Dubois L, DeRose G, Duncan A, Power AH. Preoperative point-of-care ultrasound and its impact on arteriovenous fistula maturation outcomes. J Vasc Surg. 2018; 68(4):1157-1165.
• 62. Wong V, Ward R, Taylor J, Selvakumar S, How TV, Bakran A. Factors associated with early failure of arteriovenous fistulae for haemodialysis access. Eur J Vasc Endovasc Surg 1996; 12:207-13.
• 63. Lee KG, Chong TT, Goh N, Achudan S, Tan YL, et al. Outcomes of Arteriovenous Fistula Creation, Effect of Preoperative Vein Mapping and Predictors of Fistula Success in Incident Haemodialysis Patients: A Single-Centre Experience. Nephrology (Carlton) 2017 May;22(5):382-387.
• 64. Eslami MH, Zhu CK, Rybin D, Doros G, Siracuse JJ, Farber A. Simple Predictive Model of Early Failure Among Patients Undergoing First-Time Arteriovenous Fistula Creation. Ann Vasc Surg 2016 Aug;35:46-52.
• 65. Leblanc M, Saint-Sauveur E, Pichette V. Native arteriovenous fistula for hemodialysis: what to expect early after creation? J Vasc Access 2003;4:39-44.
• 66. 2006 Updates Clinical Practice Guidelines and Recommen- dations [Internet]. Available at: http://www.kidney.org/professionals/kdoqi/pdf/12-50-0210_JAG_DCP_Guidelines- VA_Oct06_SectionC_ofC.pdf; 2006. Accessed November 18, 2015.
• 67. Remuzzi A, Bozzetto M. Biological and Physical Factors Involved in the Maturation of Arteriovenous Fistula for Hemodialysis. Cardiovasc Eng Technol 2017 Sep;8(3):273-279.
• 68. Bergan, J. J., L. Pascarella, and G. W. Schmid-Schonbein. Pathogenesis of primary chronic venous disease: insights from animal models of venous hypertension. J. Vasc. Surg. 47:183–192, 2008.
• 69. Ene-Iordache, B., and A. Remuzzi. Disturbed flow in radial-cephalic arteriovenous fistulae for haemodialysis: low and oscillating shear stress locates the sites of stenosis. Nephrol. Dial. Transplant. 27:358–368, 2012.
• 70. Ene-Iordache, B., C. Semperboni, G. Dubini, and A. Remuzzi. Disturbed flow in a patient-specific arteriovenous fistula for hemodialysis: multidirectional and reciprocating near-wall flow patterns. J. Biomech. 48:2195–2200, 2015.
• 71. Wali MA, Eid RA, Dewan M, Al-Homrany AM. Pre-existing histopathological changes in the cephalic vein of renal failure patients before arterio-venous fistula (AVF) construction. Ann Thorac Cardiovasc Surg. 2006;12:341–348.
• 72. Morena M, Bosc JY, Jaussent I, et al. The role of mineral metabolism and inflammation on dialysis vascular access failure. Vasc Access. 2006;7:77–82.
• 73. Schillinger M, Exner M, Sabeti S, et al. Excessive carotid in-stent neointimal formation predicts late cardiovascular events. J Endovasc Ther. 2004;11:229-239.
• 74. Hashimoto H, Kitagawa K, Hougaku H, Etani H, Hori M. Realtionship between C-reactive protein and progression of early carotid atherosclerosis in hypertensive subjects. Stroke. 2004;35: 1625-1630.
• 75. Erkut B, Ünlü Y, Ceviz M, et al. Primary arteriovenous fistulas in the forearm for hemodialysis: effect of miscellaneous factors in fistula patency. Ren Fail 2006; 28: 275-81.
• 76. Radoui A, Lyoussfi Z, Haddiya I, et al. Survival of the first arteriovenous fistula in 96 patients on chronic hemodialysis. Ann Vasc Surg 2011; 25: 630-3.
• 77. Goldstein SL, Ikizler TA, Zappitelli M, Silverstein DM, Ayus JC. Non-infected hemodialysis catheters are associated with increased inflammation compared to arteriovenous fistulas. Kidney Int. 2009;76:1063-1069.
• 78. J.C. Duque, L. Martinez, M. Tabbara, et al., Arteriovenous fistula maturation in patients with permanent access created prior to or after hemodialysis initiation, J. Vasc. Access 18 (3) (2017) 185–191.
• 79. Banerjee T, Kim SJ, Astor B, Shafi T, et al. Vascular Access Type, Inflammatory Markers, and Mortality in Incident Hemodialysis Patients: The Choices for Healthy Outcomes in Caring for End-Stage Renal Disease (CHOICE) Study. Am J Kidney Dis 2014 Dec;64(6):954-61.
• 80. Marrone D, Pertosa G, Simone S, et al. Local activation of interleukin 6 signaling is associated with arteriovenous fistula stenosis in hemodialysis patients. Am J Kidney Dis. 2007; 49(5):664–673.
• 81. Castellano G, Di Vittorio A, Dalfino G, et al. Pentraxin 3 and complement cascade activatio{Bibliography}n in the failure of arteriovenous fistula. Atherosclerosis. 2010;209(1):241–247.
• 82. Arbel Y, Finkelstein A, Halkin A, et al. Neutrophil/lymphocyte ratio is related to the severity of coronary artery disease and clinical outcome in patients undergoing angiography. Atherosclerosis. 2012;225(2):456–460.
• 83. Dogan M, Akyel A, Cimen T, et al. Relationship between neutrophil-to-lymphocyte ratio and saphenous vein graft disease in patients with coronary bypass. Clin Appl Thromb Hemost. 2013.
• 84. Spark JI, Sarveswaran J, Blest N, et al. An elevated neutrophil-lymphocyte ratio independently predicts mortal- ity in chronic critical limb ischemia. J Vasc Surg 2010;52: 632-6.
• 85. Chan C, Puckridge P, Ullah S, et al. Neutrophil-lymphocyte ratio as a prognostic marker of outcome in infrapopliteal percutaneous interventions for critical limb ischemia. J Vasc Surg 2014;60:661e8.