Influence of coronary artery calcification score and blood pressure variability on arteriovenous fistula in maintenance hemodialysis patients
Objective:To analyze the effects of coronary artery calcification score and blood pressure variability on arteriovenous fistula(AVF)in patients with maintenance hemodialysis(MHD).Methods:A total of 70 patients who received MHD in the Third Affiliated Hospital of Gannan Medical College from January 2023 to August 2023 were selected as the study objects.35 patients with AVF dysfunction were included in the observation group and 35 patients without AVF dysfunction were included in the control group.All patients underwent coronary CT angiography(CTA)and blood pressure monitoring.coronary artery calcification(CAC)scores and blood pressure variability(BPV)in dialysis were observed.The influencing factors of AVF function in MHD patients were analyzed by multivariate Logistic regression.The predictive value of CAC scores and BPV for AVF dysfunction was analyzed using receiver operating characteristic(ROC)curves.Results:Dialysis age,sex,blood phosphorus,hemoglobin,serum creatinine,CAC score and BPV levels in observation group were significantly higher than those in control group(P<0.05).Multiple Logistic regression analysis showed that blood phosphorus,hemoglobin,serum creatinine,CAC score and BPV level were all influential factors for AVF dysfunction(P<0.05).The area under ROC curve(AUC)of CAC score and BPV to predict AVF dysfunction in MHD patients was 0.860 and 0.868,the critical value was 246.45 and 17.03,the sensitivity was 94.29%and 88.57%,and the specificity was 71.43%and 80.00%.Conclusion:In MHD patients with AVF dysfunction,dialysis age,serum phosphorus,hemoglobin,serum creatinine level,CAC score and BPV are all influential factors for AVF dysfunction,and have good predictive value for AVF dysfunction.
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