Discussion on the Effect of Sulodexide Combined with Dipyridamole on Patients with Chronic Renal Failure after Arteriovenous Fistula Surgery

2021 ◽  
2021 ◽  
Vol 6 (1) ◽  
pp. 1287-1291
Author(s):  
Richard Santosa ◽  
Raflis Rustam ◽  
Vendry Rivaldy

Background: Arteriovenous fistula (AVF) is the preferred vascular access for hemodialysis (HD). Several factors can affect AVF maturity, such as diabetes. This study aims to determine the differences in the maturation of arteriovenous fistulas between diabetes mellitus and non-diabetes mellitus in patients with chronic kidney failure in Padang. Methods: This was a comparative cross-sectional study of patients with chronic kidney failure who underwent arteriovenous fistula surgery in Padang. The sampling technique in this study was consecutive sampling. The analysis was carried out using statistical analysis according to the existing data scale and using SPSS software. Results: This study involved 46 patients with chronic kidney failure who underwent arteriovenous fistula surgery in Padang, of which 23 patients with diabetes mellitus and 23 patients with non-diabetes mellitus. The diameter of the arteriovenous fistula between diabetes mellitus and non-diabetes mellitus in patients with chronic renal failure had a significant difference (p<0.05). There was no significant difference in flow, depth, and maturation of arteriovenous fistulas in patients with diabetes mellitus and non-diabetes mellitus with chronic renal failure. Conclusion: There is no difference in the maturation of arteriovenous fistula between patients with diabetes mellitus and non-diabetes mellitus


Vascular ◽  
2018 ◽  
Vol 27 (3) ◽  
pp. 284-290 ◽  
Author(s):  
Mehmet Erin Tüysüz ◽  
Mehmet Dedemoğlu

Objectives There is an increased calcium phosphate product level causing the formation of calcification in the arterial wall and thus decreased quality of fistula in patients with chronic renal failure. The purpose of our study is to verify the relationship between arteriovenous fistula re-operation and high calcium phosphate product level. Methods Seventy-nine consecutive patients with chronic renal failure between April 2016 and February 2018 were included in the study. Patients having calcium phosphate product level ≥50 mg2/dl2 were defined as group 1, whereas those having <50 mg2/dl2 were defined as group 2. Primary outcome of interest was the need for re-operation during the follow-up and to determine the risk factors for re-operation. To determine independent predictors for re-operation, multivariate logistic regression model was used. Results The rates of redo and tredo operation were significantly higher in group 1 compared to group 2 ( p = 0.01 and 0.04). In multivariate analysis, phosphate (OR: 1.84, 95% CI: 1.00–3.40, p = 0.05) and triglyceride (OR: 1.01, 95% CI: 1.00–1.02, p = 0.04) levels for redo operation and calcium phosphate product level (OR: 1.11, 95% CI: 1.01–1.22, p = 0.03) for tredo operation were found to be independent predictors. Conclusions High calcium phosphate product level leads to increased risk of arteriovenous fistula re-operation by causing arterial stiffness in this patient group. Additionally, these re-operations place additional burden on morbidity and cost efficacy. Thus, we recommend keeping the calcium phosphate product level at the optimal level in these patients to avoid both the risk of arteriovenous fistula re-operation and the other cardiovascular problems.


2014 ◽  
Vol 1 ◽  
pp. 17-20 ◽  
Author(s):  
Faruk Cingoz ◽  
Celalettin Gunay ◽  
Adem Guler ◽  
Mehmet Ali Sahin ◽  
Bilgehan Savas Oz ◽  
...  

2009 ◽  
Vol 10 (3) ◽  
pp. 160-166 ◽  
Author(s):  
Ali Akbar Beigi ◽  
Amir Mir Mohammad Sadeghi ◽  
Ali Reza Khosravi ◽  
Mehdi Karami ◽  
Hassan Masoudpour

Introduction Access to the vascular system is necessary in patients with chronic renal failure planned to undergo dialysis. One of the complications of end-stage renal disease patients is pulmonary hypertension (PHT). Temporary arterio-venous access closure and successful kidney transplantation causes a significant fall in cardiac output and pulmonary artery pressure (PAP), indicating the possibility that excessive pulmonary blood flow is involved in the pathogenesis of the disease. We attempted to study the relationship of PHT with arteriovenous fistula (AVF) creation, as well as to assess the relationship between AVF flow and fistula characteristics. Methods Fifty patients were included in the study. Echocardiography was used to evaluate systolic PAP, cardiac output (CO), and ejection fraction (EF) before creating the AVF. After a follow-up interval of at least 6 months, a second echocardiographic assessment and a Doppler sonographic assessment of their fistula flow were carried out. Complete data were available for 34 patients. Results Study data were collected from 34 patients, 28 males and 6 females with a mean age of 52 yrs ranging from 15–78 yrs. The data showed a statistically significant positive correlation between fistula flow and PAP2 and PAP changes (p<0.05). Mean fistula flow was 1322 ml/min in patients without PHt and 2750 ml/min in patients with PHT. this difference (1428 ml/ min) was statistically significant (p=0.03). We found a significant negative correlation between PAP1 and EF1 and PAP2 and EF2 (p<0.05). In addition, the mean EF2 in patients without PHT was 57% in contrast to 46% in patients with PHT. Mean fistula flow in radial fistulae (mean=422 ml/min, range: 370–474 ml/min) was significantly less than brachial fistulae (mean=1463 ml, range: 270–3300 ml/min) (p=0.03). Mean systolic PAP2 of 14.8 mmHg in transplanted patients was 5.9 mmHg less than those who were not transplanted (20.7 mmHg). Diabetes was the most common cause of renal failure and diabetics had a significant reduction in their EF (15.5%) compared with non-diabetic patients (1% reduction) (p=0.016). Conclusion Fistula flow, PAP and EF of all patients should be checked at least 6 months after fistula creation. Patients with higher fistula flow rates and patients with diabetes mellitus need to be more closely observed. In addition, elderly patients with significant cardiac and other comorbidities may be more prone to develop symptoms after AVF creation


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