Hong Chen, Na Song, Ai-mei Li, Qin Dai, Yu-ting Liu, Shi-kun Yang
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引用次数: 0
摘要
动静脉瘘(AVF)是维持血液透析(MHD)患者的主要透析血管通路。维生素D (VD)是一种脂溶性类固醇激素，与血管内皮功能密切相关。本研究旨在探讨HD患者VD代谢物与AVF衰竭之间的关系。方法本研究纳入2010年1月至2020年1月期间使用AVF的443例HD患者。这些患者的AVF手术是由同一位医生新创建的。我们使用卡方检验分析AVF通畅率。采用单因素和多因素logistic回归分析探讨AVF失效的危险因素。通过生存分析探讨不同血清25-羟基维生素D (25(OH)D)浓度下AVF的存活情况。结果Logistic回归分析显示:男性;年龄;体重指数;血清白蛋白、甘油三酯、磷、25(OH)D、iPTH和血红蛋白水平，高血压、冠心病、糖尿病、中风和抗血小板药物使用史;吸烟习惯不是AVF衰竭的危险因素。VD缺乏组与非VD缺乏组AVF失败发生率比较，差异无统计学意义(25.0% vs 30.8%， p = 0.344)。25(OH)D水平大于20 ng/mL的患者1年、3年和5年AVF衰竭发生率分别为26%、29%和37%，25(OH)D水平小于20 ng/mL的患者1年AVF衰竭发生率为27%。此外，Kaplan-Meier分析表明，在使用AVF的50个月内计算两组AVF的累积生存率时，没有注意到显著差异。结论25(OH)D缺乏与AVF衰竭发生率无关，25(OH)D缺乏对AVF长期累积生存率无显著影响。
Association of vitamin D metabolites with arteriovenous fistula function in hemodialysis patients: A single center study
Introduction
Arteriovenous fistula (AVF) is a primary dialysis vascular access commonly used for maintaining hemodialysis (MHD) patients. Vitamin D (VD) is a fat-soluble steroid hormone that is closely related to vascular endothelial function. This study aimed to investigate the association between VD metabolites and AVF failure in patients undergoing HD.
Methods
This study included 443 HD patients using AVF between January 2010 and January 2020. The AVF operations in these patients were newly created by the same physician. We analyzed the AVF patency rates using the chi-square test. Univariate and multivariate logistic regression analyses were performed to explore risk factors for AVF failure. Survival analysis was performed to explore AVF survival at different serum 25-hydroxyvitamin D (25(OH)D) concentrations.
Results
Logistic regression analyses showed that male sex; age; BMI; serum albumin, triglyceride, phosphorus, 25(OH)D, iPTH and hemoglobin levels, history of hypertension, CHD, diabetes, stroke, and antiplatelet drug use; and smoking habits were not risk factors for AVF failure. The failure incidence rates of AVF in subjects in the VD deficiency and non VD deficiency group were not statistically significant (25.0% vs. 30.8%, p = 0.344). The AVF failure incidence rates at 1, 3, and 5 years in the patients with 25(OH)D levels more than 20 ng/mL were 26%, 29%, and 37%, respectively, and the one-year AVF failure incidence rates were 27% in the patients with 25(OH)D levels less than 20 ng/mL. In addition, the Kaplan–Meier analysis suggested that the no significant differences were noted when calculating the cumulative survival rates of AVF between the two groups within 50 months of AVF using.
Conclusion
Our findings suggest that 25(OH)D deficiency is not associated with AVF failure incidence rates, and that 25(OH)D deficiency has no significant impact on long-term cumulative AVF survival rate.
期刊介绍：
Hemodialysis International was originally an annual publication containing the Proceedings of the International Symposium on Hemodialysis held in conjunction with the Annual Dialysis Conference. Since 2003, Hemodialysis International is published quarterly and contains original papers on clinical and experimental topics related to dialysis in addition to the Annual Dialysis Conference supplement. This journal is a must-have for nephrologists, nurses, and technicians worldwide. Quarterly issues of Hemodialysis International are included with your membership to the International Society for Hemodialysis.
The journal contains original articles, review articles, and commentary to keep readers completely updated in the field of hemodialysis. Edited by international and multidisciplinary experts, Hemodialysis International disseminates critical information in the field.
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