Risk factors for the formation of arteriovenous fistula thrombosis in patients treated with chronic hemodialysis

Abstract

Introduction. Complications related to vascular access, alongside cardiovascular diseases, constitute the primary cause of hospitalization among patients undergoing hemodialysis. Thrombosis stands out as the most prevalent cause of arteriovenous fistula dysfunction. The research aimed to identify the risk factors contributing to thrombosis formation of the first arteriovenous fistula. Material and Methods. The study spanned one year and involved 40 patients who initiated hemodialysis through their first arteriovenous fistula at the University Clinical Centre of Vojvodina. The parameters analyzed included demographic, biochemical, and clinical factors, as well as the therapy given. Results. Among the 40 patients, 67% were male. The majority (57.5%) were aged over ? 60 years. Hypertension was the most prevalent comorbidity, affecting 35% of patients. Arteriovenous fistula thrombosis was diagnosed in 32% of patients. A logistical regression model was employed to determine predictors of arteriovenous fistula thrombosis. The analysis revealed that the patients with a body mass index greater than > 25 kg/m2, had a 1.5 times higher risk of thrombosis formation. Similarly, individuals with blood pressure exceeding > 140/90 mmHg had nearly a twofold increased risk, while those in the 45-59 age group had a fourfold higher risk. Patients who received anticoagulant therapy before arteriovenous fistula formation had a 16 times lower risk of thrombosis, and nearly 33 times lower risk with the application of angiotensin-converting-enzyme inhibitors/angiotensin II receptor blocker after arteriovenous fistula formation. Conclusion. Significant predictors of thrombosis formation of the first arteriovenous fistula among hemodialysis patients included body mass index greater than > 25 kg/m2, blood pressure values exceeding > 140/90 mmHg, and age group of 45 - 69 years.