The effect of hemoglobin level on arteriovenous fistula survival in Iranian hemodialysis patients
The effect of hemoglobin level on arteriovenous fistula survival in Iranian hemodialysis patients
J Vasc Access 2008; 9(2): 133 - 136
Article Type: ORIGINAL ARTICLE
Authors
R. Hadipour, F. Gholipour, M. Khavanin Zadeh
Abstract
Objective: End-stage renal disease (ESRD) poses steadily growing challenges to health care systems worldwide. Renal replacement therapy with hemodialysis (HD) or kidney transplantation is the only possibility for ESRD patient survival. A complete correction of anemia in HD patients may lead to an increased risk of vascular arteriovenous fistula (AVF) primary failure; some studies have demonstrated that decreased levels of hemoglobin (Hb) had adverse effects on cardiac and brain function. This study was designed to evaluate the impact of different risk factors, especially the Hb level on AVF survival. Methods: Prospective observational data were analyzed from a non-randomized sample (n=100) of HD patients who were referred for first AVF creation between April 2005 and December 2006 with <1 month on HD. The relative risk (RR) of access primary failure was evaluated in four different groups of patients divided according to their Hb levels (<8, 8-10, 10-12, and >12 g/dL). Other factors possibly influencing vascular access (VA) survival were also considered including gender, age, smoking, diabetes, hypertension, parathyroid hormone levels, ACE inhibitor intake and triglyceride levels. The analyses were performed using SPSS v.11.5, Kaplan-Meier analysis, Cox’s regression and log rank test. Results: There was a statistically significant higher risk of AVF primary failure in patients with Hb <8 g/dL (RR=1.41; p=0.01), diabetes (RR=1.21; p=0.05), age>60 yrs (RR=1.41; p=0.06) were identified as predictive factors for AVF primary failure. ACE inhibitor intake (RR=0.45; p=0.01) was found to be protective. Conclusion: Correction of serum Hb level can lead to a better result in VA survival and ACE inhibitor intake was found to be a protective factor.
Article History
Article usage statistics
The blue line displays unique views in the time frame indicated.
The yellow line displays unique downloads.
Views and downloads are counted only once per session.
Authors
- Hadipour, R. [PubMed] [Google Scholar]
- Gholipour, F. [PubMed] [Google Scholar]
-
Khavanin Zadeh, M. [PubMed] [Google Scholar]
Hasheminejad Kidney Center, Iran University of Medical Science, Tehran - Iran