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Arteriovenous fistulas and digital hypoperfusion ischemic syndrome in patients on hemodialysis

World Journal of Nephrology 2013年第2期2卷 26-30页

作者： Radojica V Stolic Goran Z Trajkovic Dijana J Miric Bojana Kisic zorana djordje Goran Lj Azanjac Marijana S Stanojevic Dragica Z Stolic Medical Faculty University of Pristina Clinical Center Kragujevac Faculty of Medicine University of Kragujevac Health Center Pristina

AIM： To determine survival parameters as well as char-acteristics of patients with this syndrome. METHODS： The investigation was conducted over a period of eight years, as a prospective, non-random-ized, clinical study which included 204 patients, treated by chronic hemodialysis. Most patients received hemo-dialysis 12 h per week. As vascular access for hemodi-alysis all subjects had an arteriovenous fstulae. Based on surveys the respondents were divided into groups of patients with and without digital hypoperfusion isch-emic syndrome. Gender, demographic and anthropo-metric characteristics, together with comorbidity and certain habits, were recorded. During this period 34.8% patients ***： Patients with digital hypoperfusion ischemic syndrome were older than those without ischemia （P = 0.01）. Hemodialysis treatment lasted signifcantly lon-ger in the patients with digital hypoperfusion ischemic syndrome （P = 0.02）. The incidence of cardiovascular disease （P 〈 0.001） and diabetes mellitus （P = 0.01）, as well as blood fow through the arteriovenous fstula （ P = 0.036）, were higher in patients with digital hypoper-fusion ischemic syndrome. Statistically significant dif-ferences also existed in relation to oxygen saturation （P = 0.04）. Predictive parameters of survival for patients with digital hypoperfusion ischemic syndrome were： adequacy of hemodialysis （B = -3.604, P 〈 0.001）, hypertension （B = -0.920, P = 0.018）, smoking （B = -0.901, P = 0.049）, diabetes mellitus （B = 1.227, P = 0.005）, erythropoietin therapy （B = 1.274, P = 0.002） and hemodiafltration （B = -1.242, P = 0.033）. Kaplan-Meier survival analysis indicated that subjects with and without digital hypoperfusion ischemic syndrome dif-fered regarding the length of survival （P 〈 0.001）, i.e. , patients with confrmed digital hypoperfusion ischemic syndrome died ***： Survival was signifcantly longer in the patients without digital hypoperfusion ischemic syn-drome.

关键词： Digital hypoperfusion ischemic syndrome Predictive parameters Survival Arteriovenous fistula Hemodialysis

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