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Digital pressure in haemodialysis patients with brachial arteriovenous fistula

BACKGROUND & OBJECTIVES: The pathophysiological mechanisms involved in distal pressure changes following arteriovenous fistula (AVF) creation in patients with end-stage renal disease (ESRD) are not completely understood. This study was aimed to assess digital pressure changes post-AVF creation a...

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Autores principales: Oprea, Alexandru, Molnar, Adrian, Scridon, Traian, Mircea, Petru Adrian
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer - Medknow 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6607816/
https://www.ncbi.nlm.nih.gov/pubmed/31249203
http://dx.doi.org/10.4103/ijmr.IJMR_415_17
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author Oprea, Alexandru
Molnar, Adrian
Scridon, Traian
Mircea, Petru Adrian
author_facet Oprea, Alexandru
Molnar, Adrian
Scridon, Traian
Mircea, Petru Adrian
author_sort Oprea, Alexandru
collection PubMed
description BACKGROUND & OBJECTIVES: The pathophysiological mechanisms involved in distal pressure changes following arteriovenous fistula (AVF) creation in patients with end-stage renal disease (ESRD) are not completely understood. This study was aimed to assess digital pressure changes post-AVF creation and to identify the factors that might influence these changes in ESRD patients. METHODS: In this prospective study, 41 patients with ESRD underwent AVF creation. Basal digital pressure (BDP), digital brachial index (DBI), calcium, phosphorus and blood urea levels were assessed preoperatively. BDP, DBI, vein and artery diameters, and AVF blood flow were also evaluated at one and two month(s) post-AVF creation. RESULTS: Mean BDP significantly decreased from 131.64±25.86 mmHg (baseline) to 93.15±32.14 and 94.53±32.90 mmHg at one and two months post-AVF creation, respectively (P<0.001). Mean DBI significantly decreased one month post-AVF creation versus baseline (0.70±0.18 vs. 0.89±0.17 mm, P<0.001) and remained similar at two versus one month(s) postoperatively (0.70±0.23 vs. 0.70±0.18 mm). At both postoperative timepoints, no correlation between DBI decrease and increased artery and vein diameters or fistula blood flow was observed. Mean DBI difference between patients with previous ipsilateral access versus those without was not significant from pre to one month postoperatively. No correlation was observed between baseline phosphorus, calcium and blood urea nitrogen and DBI changes. INTERPRETATION & CONCLUSIONS: Our findings suggest that decrease in distal pressure following AVF creation may not be influenced by the arterial remodelling degree, vein diameter or fistula flow. In uraemic patients, those with low calcium and/or increased phosphorus, no association between these parameters and DBI changes could be observed.
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spelling pubmed-66078162019-07-17 Digital pressure in haemodialysis patients with brachial arteriovenous fistula Oprea, Alexandru Molnar, Adrian Scridon, Traian Mircea, Petru Adrian Indian J Med Res Original Article BACKGROUND & OBJECTIVES: The pathophysiological mechanisms involved in distal pressure changes following arteriovenous fistula (AVF) creation in patients with end-stage renal disease (ESRD) are not completely understood. This study was aimed to assess digital pressure changes post-AVF creation and to identify the factors that might influence these changes in ESRD patients. METHODS: In this prospective study, 41 patients with ESRD underwent AVF creation. Basal digital pressure (BDP), digital brachial index (DBI), calcium, phosphorus and blood urea levels were assessed preoperatively. BDP, DBI, vein and artery diameters, and AVF blood flow were also evaluated at one and two month(s) post-AVF creation. RESULTS: Mean BDP significantly decreased from 131.64±25.86 mmHg (baseline) to 93.15±32.14 and 94.53±32.90 mmHg at one and two months post-AVF creation, respectively (P<0.001). Mean DBI significantly decreased one month post-AVF creation versus baseline (0.70±0.18 vs. 0.89±0.17 mm, P<0.001) and remained similar at two versus one month(s) postoperatively (0.70±0.23 vs. 0.70±0.18 mm). At both postoperative timepoints, no correlation between DBI decrease and increased artery and vein diameters or fistula blood flow was observed. Mean DBI difference between patients with previous ipsilateral access versus those without was not significant from pre to one month postoperatively. No correlation was observed between baseline phosphorus, calcium and blood urea nitrogen and DBI changes. INTERPRETATION & CONCLUSIONS: Our findings suggest that decrease in distal pressure following AVF creation may not be influenced by the arterial remodelling degree, vein diameter or fistula flow. In uraemic patients, those with low calcium and/or increased phosphorus, no association between these parameters and DBI changes could be observed. Wolters Kluwer - Medknow 2019-03 /pmc/articles/PMC6607816/ /pubmed/31249203 http://dx.doi.org/10.4103/ijmr.IJMR_415_17 Text en Copyright: © 2019 Indian Journal of Medical Research http://creativecommons.org/licenses/by-nc-sa/4.0 This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
spellingShingle Original Article
Oprea, Alexandru
Molnar, Adrian
Scridon, Traian
Mircea, Petru Adrian
Digital pressure in haemodialysis patients with brachial arteriovenous fistula
title Digital pressure in haemodialysis patients with brachial arteriovenous fistula
title_full Digital pressure in haemodialysis patients with brachial arteriovenous fistula
title_fullStr Digital pressure in haemodialysis patients with brachial arteriovenous fistula
title_full_unstemmed Digital pressure in haemodialysis patients with brachial arteriovenous fistula
title_short Digital pressure in haemodialysis patients with brachial arteriovenous fistula
title_sort digital pressure in haemodialysis patients with brachial arteriovenous fistula
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6607816/
https://www.ncbi.nlm.nih.gov/pubmed/31249203
http://dx.doi.org/10.4103/ijmr.IJMR_415_17
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