Patency with antiplatelet treatment after vascular access intervention therapy: A retrospective observational study

Abstract

Background: Vascular access (VA) intervention therapy (VAIVT) has been increasingly used for treating VA failure (VAF) in patients undergoing hemodialysis; however, clinical evidence demonstrating the efficacy of prevention of VAF after VAIVT is limited. Therefore, we aimed to assess characteristics of patients developing VAF after VAIVT and analyze risk factors for VAF after VAIVT. Methods: This retrospective study included 96 patients with VAF who underwent ultrasound-guided VAIVT by interventional nephrologists between January 2013 and March 2018 at the Department of Nephrology, University of Tokyo Hospital, Japan. Patient information included age, sex, medication history, and comorbidities that could potentially affect VAF onset. Patients were categorized into two groups based on antiplatelet treatment. Multivariate Cox regression analysis was performed for evaluating effect of various factors on VAF after VAIVT. Results: Median age of patients at the time of VAIVT was 71 years (interquartile range 63-79); the most prevalent etiology underlying end-stage renal disease was diabetic nephropathy (40.7%). Comparison between the antiplatelet and non-Antiplatelet groups revealed that the incidence of VAF was significantly lower in the antiplatelet group. Multivariate analysis revealed that antiplatelet treatment was associated with a lower risk of VAF after VAIVT. Conclusion: Administration of antiplatelet agents was associated with a significant reduction in VAF risk after VAIVT.