Chinese Journal of Blood Purification

Chinese Journal of Blood Purification ›› 2023, Vol. 22 ›› Issue (12): 939-943.doi: 10.3969/j.issn.1671-4091.2023.12.012

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Survival analysis of arteriovenous graft in maintenance hemodialysis patients: a retrospective cohort study

ZHU Wei, JIANG Jun, PENG Li, WANG Peng, ZHU Cheng-xiu, LAN Lei   

  1. Graduate School of Bengbu Medical College, Anhui 233030, China; 2Department of Nephrology, The First Affiliated Hospital, Division of Life Sciences and Medicine, University of Science and Technology of China, Anhui 230001, China
  • Received:2023-06-14 Revised:2023-09-25 Online:2023-12-12 Published:2023-11-30
  • Contact: 233030 蚌埠，1蚌埠医学院研究生院； 230001 合肥，2中国科学技术大学附属第一医院(安徽省立医院)肾内科 E-mail:lanlei1976@126.com

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Abstract: Objective  To assess the primary patency rate and secondary patency rate of arteriovenous graft (AVG), and to analyze the risk factors for survival of AVG in maintenance hemodialysis (MHD) patients.  Methods  Baseline data of the MHD patients undergoing AVG surgery at the Department of Nephrology, Anhui Provincial Hospital from December 2016 to June 2022 were retrospectively recruited. Patients were followed up for survival of AVG and prognosis of the patients. Kaplan-Meier method was used to calculate technical survival rate of AVG. Cox regression model was used to analyze the risk factors for primary patency and secondary patency of AVG. The risk ratio (HR) and 95% confidence interval (CI) were calculated for every risk factor.  Results  A total of 51 MHD patients undergoing AVG surgery were collected, and 43 of the 51 patients were finally enrolled in this study because of loss of follow-up in 8 patients. The primary patency and secondary patency periods were 6 (1, 12) and 8 (2, 30) months respectively in the 43 patients. After the surgery for 6, 12 and 18 months, the primary patency rates were 53.9%, 29.0% and 19.9% respectively, and the secondary patency rates were 80.8%, 71.1% and 67.1% respectively. Univariate Cox regression showed that history of central venous catheterization (HR 2.091, 95% CI: 1.013～4.319, P=0.046) was the risk factor for primary patency rate of AVG, and female was the risk factor for secondary patency rate of AVG (HR 3.085, 95% CI:1.022～9.305, P=0.046).  Conclusion  The primary patency and secondary patency periods of AVG were shorter and the long-term patency rate of AVG was lower, indicating the difficulties for a higher long-term patency rate of AVG. Central vein catheterization should be avoided in patients before AVG surgery. AVG should be carefully used for blood access in female MHD patients, Close follow-up after the surgery is required to treat complications in time to improve the secondary patency rate.

Key words: Hemodialysis, Arteriovenous graft, Survival analysis, Risk factor

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