Abstract: Objective To explore the risk factors for restenosis after percutaneous transluminal angioplasty (PTA) in autologous arteriovenous fistulas (AVF) of hemodialysis patients.  Methods  A total of 65 patients on hemodialysis after PTA for the first time were selected as the research subjects. They were followed up for 12 months. For patients who developed restenosis within 12 months, the relevant data at the time of restenosis were collected. For those without restenosis, the relevant data at the end of the follow-up were also recruited. The differences in relevant indicators of the patients were analyzed. Cox univariate and multivariate regression analysis was used to analyze the risk factors for restenosis after PTA. Kaplan-Meier and log rank tests were used for univariate survival analysis.  Results  ①Among the 65 patients followed-up for 12 months, 27 developed restenosis within 12 months. The patency rates at one month, 3, 6, 9 and 12 months after surgery were 100%, 93.85%, 73.85%, 63.08% and 58.46%, respectively.  ②Patients who developed restenosis after the first PTA had shorter AVF usage time (t=2.832, P=0.006), higher calcium-phosphorus product (t=2.240, P=0.029), lower blood magnesium (t=2.090, P=0.041), lower PTH (t=2.587, P=0.012), higher β2-microglobulin (t=3.024, P=0.003), and hypotension during dialysis (χ2=4.260, P=0.039). ③COX univariate and multivariate regression analysis revealed that AVF usage time (HR=0.980, 95% CI:0.963～0.997, P=0.020), calcium-phosphorus product (HR=1.045, 95% CI:1.009～1.082, P=0.013), β2-microglobulin (HR=1.080, 95% CI:1.006～1.158, P=0.033), and hypotension during dialysis (HR=3.354, 95% CI:1.548～7.269, P=0.002) were the main risk factors  for restenosis after the first PTA.  Conclusion  For hemodialysis patients undergoing the first PTA in AVF, the occurrence of AVF restenosis can be reduced by controlling chronic kidney disease-mineral and bone disorder (CKD-MBD), strengthening the clearance of middle and large molecular toxins, and preventing hypotension during dialysis. 

Key words: Autologous arteriovenous fistula, Maintenance hemodialysis, Percutaneous transluminal angioplasty, Restenosis