Assessment of The Effect of Blood Pressure on The Maturation of Arteriovenous Fistula and Grafts

Chronic kidney disease is an ailing condition that in the final stages can lead the patient to renal replacement therapies such as dialysis. An arteriovenous fistula (AVF) with proper function and maturation is needed with this regard. The aim of this study was to evaluate the effect of blood pressure on the function and maturation of AVF and AVG.

This retrospective cross-sectional study was performed between September 2016 and March 2019 on all patients with chronic renal failure, who referred to the Alavi Vascular Surgery Hospital as candidates for hemodialysis and underwent AVF implementation by the researchers. Using a predesigned checklist, the hospital records of all patients were reviewed and data including the demographic information of patients (age and sex), previous medical history (diabetes, hypertension), smoking status and blood pressure of the patient before and after surgery were extracted. In order to follow the patients and evaluate the function and maturation of the fistula, the dialysis centers in Mashhad were contacted and information about the successful dialysis of the patients was recorded. Data were extracted from the forms and entered into SPSS software and at the end, patients' blood pressure was compared between functional and unfunctional groups and also in terms of access type.

Totally, 298 cases were enrolled in the study and classified into two groups including 242 (81.2%) functional AVFs and 56 (18.8%) unfunctional AVFs. The mean age of the patients was 55.15±17.93 years and the median was 58.5 (67.0-43.0) years old. Moreover, 152 patients (51.0%) were male and 146 patients (49.0%) were female. There was no significant difference regarding age (p=0.057) and gender (p=0.290) between the two study groups. Furthermore, underlying diseases (diabetes and hypertension) showed significant difference between the two study groups (p<0.001). Only, diabetes relative frequency showed significant difference between fistula and graft groups (p=0.022). The median systolic (SBP) and diastolic blood pressure (DBP) was significantly higher in functional group compared to the unfunctional (p<0.05). However. There was no significant difference regarding the median SBP and DBP between the two types of access including fistula and graft (p>0.05).

Our study revealed that probably blood pressure paly and important role in the function and maturation of AVF.