SP593THE RISK FACTOR EVALUATION OF OCCLUSION AFTER SURGICAL CONSTRUCTION OF VASCULAR ACCESS IN PREDIALYSIS CHRONIC KIDNEY DISEASE

Abstract

INTRODUCTION AND AIMS: Vasospasm and thrombosis are considered to be the main causes of occlusion after surgical construction of an arteriovenous fistula (AVF) or arteriovenous graft (AVG) in predialysis chronic kidney disease. The method of predicting possible occlusion remains unknown, although severe arteriosclerosis is assumed to be more occlusive. METHOD(S): This is a single-centre retrospective study involving patients who underwent surgical construction of a vascular access at our centre between September 2014 and October 2017.We investigated the relationship among postoperative occlusion, echocardiographic findings and related parameters, including vascular involvement such as ankle brachial index (ABI), toe brachial index (TBI) and pulse wave velocity (PWV). RESULT(S): After surgical construction of an AVF or AVG, haemodialysis was performed in a total of 241 patients (63.3%). The average age of the patients was 70 years (age range: 63-[Editor1] 71 years), and the number of male patients was 155 (64.3%). Postoperative occlusion was detected in 12 (5.0%) patients. A significant difference between the postoperative occlusion and non-occlusion groups was not observed in relation to cardiac evaluation, ABI and TBI. The PWV value significantly differed between the two groups, with the postoperative occlusion group comparatively showing a lower value (univariate analysis, Wilcoxon signed-rank test, p= 0.019). CONCLUSION(S): Vasospasm of the shunt blood vessel tends to be reported in patients with mild arteriosclerosis. A lower PWV value, which indicates mild arteriosclerosis, may be related to postoperative occlusions by vasospasm.