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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...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Wolters Kluwer - Medknow
2019
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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. |
format | Online Article Text |
id | pubmed-6607816 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Wolters Kluwer - Medknow |
record_format | MEDLINE/PubMed |
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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