Risk factors of autologous arteriovenous fistula nonfunction in long-term hemodialysis patients

Objective  To explore the influencing factors for the risk of autologous arteriovenous fistula (AVF) nonfunction in patients on hemodialysis (HD) for >10 years.

Methods  A total of 50 patients on HD >10 years were assigned into two groups of nonfunction (n=26) and function (n=24) according to the presence or absence of AVF nonfunction. General profiles and laboratory parameters were compared between two groups for evaluating the effects of various indicators on AVF nonfunction.

Results Initial cannulation time for AVF was significantly earlier in nonfunction group than that in function group. The levels of cholesterol and retinol-binding protein were significantly higher than those in function group. Inter-group differences also existed in the proportions of different cannulation techniques and blood flow distribution (P<0.05). Multivariate Cox regression analysis indicated that advanced age at an initial hemodialysis, upper arm AVF, area puncture cannulation technique and initial cannulation time were the significant influencing factors for AVF nonfunction.

Conclusions  Patients with forearm AVF and a longer initial cannulation time are more prone to AVF while advanced age and area puncture cannulation technique may elevate the risks of AVF nonfunction.