Objectives: To find predictors that affect initial autogenous hemodialysis access maturation Methods: All patients undergoing autogenous hemodualysis access creation from August 2008 to December 2010 were retrospectively reviewed. We investigated type of fistula, maturation rates based on patients' clinical characteristics and findings on physical examination and preoperative DUS mapping studies. The following factors were analyzed: age, gender, body-mass index (BMI), diabetes, hypertension, hyperdipidemia, congestive heart failure (CHF), coronary artery disease (CAD), cerebrovascular disease (CVD), ejection fraction (EF, %), preoperative DUS artery and vein size, prior central catheter placement. Results: 383 vascular access procedures were performed in 371 patients. Three hundred thirty one (86.4%) were autogenous AVF, among which a primary first AVF was created in 283 (85.5%); 186 (65.7%) with radiocephalic AVF (RCAVF), 95 (33.6%) with brachiocephalic AVF (BCAVF), 2 (0.7%) with basilic vein transposition (BVT). All patients underwent preoperarive DUS mapping for artery and vein sizing. RCAVF, BCAVF, BVT had 88.2%, 82.1%, 100% maturation rates in mean 39 days after creation. By univariate analysis, diabetes, CAD and vein diameter were associated with maturation rates, but therewas no significant factor by multivariate analysis. In RCAVF (n=186), CHF (P = .041), minimal forearm CV (CVmin) size (P=.007), mean forearm CV (CVmean) size (P = .013), and CVmin over 2mm (P = .002) significantly affected maturation by univariate analysis. By multivariate logistic regression analysis, CVmin over 2mm (P = .001) and non-diabetes (P = .046) were independent predictor of RCAVF maturation. Conclusions: In RCAVF, high ejection fraction, nondiabetes, CVmin over 2mm were independent predictors of primary maturation. Preoperative DUS would be recommended to encourage the use of native AVF and to promote its maturation rate.
Park, Y. J., Yang, S. S., Park, K. M., Kim, D.-I., & Kim, Y.-W. (2012). RR27. Predictors of Maturation after a Native First Arteriovenous Fistula Creation. Journal of Vascular Surgery, 55(6), 100S. https://doi.org/10.1016/j.jvs.2012.03.236