Combined diameter of radial artery near elbow,age and eGFR for prediction radiocephalic autogenous arteriovenous fistula
Objective To identify factors affecting the maturity of radiocephalic autogenous arteriovenous fistula(RCAVF),and predict the possibility of maturity with significant correlation factors.Methods From July 2017 to December 2019,a total of 257 end-stage renal disease patients with newly created RCAVF were enrolled,which included 169 males and 88 females;aged 24-90 years old with mean age of 59.4 years old;course of disease was 0.81-5.00 years with mean course of 3.53 years.There were 217 cases(84.4％)of hypertension and 166 cases(64.6％)of diabetes.The preoperative vascular ultrasonography was performed to record basic information(age,gender),basic diseases(hypertension,diabetes and kidney disease)and serologi-cal indicators[urea,creatinine,uric acid,cystatin C and glomerular filtration rate(eGFR)].The maturation of RCAVF was followed up for 6-month after operation,the univariate logistic regression and multivariate logistic regression were used to analyze fac-tors affecting maturation of RCAVF,and the significant related factors were obtained.The receiver operating characteristic(ROC)curve was drawn to obtain area under curve(AUC),optimal critical value,sensitivity and specificity.According to the optimal critical value,the indexes with statistical significance of multi-factor differences were combined to obtain the com-bined diagnostic efficacy.Results The RCAVF of the left forearm was performed in 210 cases(81.7％),and the right forearm was performed in 47 cases.All of the operation were was successful.There were 182 cases were matured(mature group),and 75 with immature(immature group)after 6-month of follow-up.The age and eGFR of RCAVF immature group were higher than those of mature group(age:P=0.036;eGFR:P=0.008).In RCAVF mature group,the diameter of radial artery near wrist and diameter of radial artery near elbow and creatinine were statistically significantly higher than those in immature group(diameter of radial artery near wrist and elbow were P＜0.001;creatinine:P=0.002).The univariate Logistic regression showed that age,the diameter of radial artery near wrist and near elbow,the diameter of cephalic vein near elbow,creatinine and eGFR were all significantly associated with maturation of RCAVF(P＜0.05).The multivariate Logistic regression analysis showed that age and eGFR were the factors impeded RCAVF maturation,and diameter of radial artery near elbow was factor promoted RCAVF maturation(P＜0.05).The combined prediction obtained the highest AUC value of 0.661,the highest specificity of 94.29％,and the highest sensitivity of 96.00％(P＜0.05).Conclusion It is demonstrated that the combination of radial artery proximal elbow diameter,age and eGFR could predict the maturity of RCAVF,which obtain better diagnostic efficacy,sensitivity and specificity,and provide reference for evaluating whether patients are suitable for dialysis with RCAVF.
NETL
NSTL
万方数据
维普
