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Less primary fistula failure in hypertensive patients

Journal of Human Hypertension volume 32, pages 311–318 (2018)Cite this article

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Abstract

End stage renal disease (ESRD) patients suffer from advanced renal diseases and actually nonfunctioning kidneys, and need kidney transplantation or dialysis. Hemodialysis (HD) is the most used method and requires a vascular access (VA). Arteriovenous fistula (AVF) is the first choice of VA over the world for having least morbidity and mortality. Despite the wide-spread use of AVFs, the rate of AVF failures are notable. Detecting the factors that cause AVF failure can reduce repeating VA surgeries and hospitalization of ESRD patients. Present research studies 480 Iranian HD patients who underwent AVF surgery from 2010 to 2017 and aged 18–90 years old, using data mining techniques. (i) The AVF failure rate was equal to 8.96%, such that AVF failure has occurred in 3.54% and 5.52% of HD patient with and without hypertension, respectively. (ii) The rate of non-failure AVF in hypertensive patients is 61.46%, whereas the same rate for patients with negative history of hypertension reaches to 29.58%. (iii) Hypertension has a significant inverse association with AVF failure (Spearman’s ρ = −0.160, P-value ≤ 0.005). (iv) The decision tree (with accuracy rate = 92.24%) shows less AVF failure in hypertsensive patients (5.53%) comparing with non-hypertensive patients (15.09%). (v) The AVFs with greater failure rates and non-hypertensive HD patients were clustered together. “Significantly lower risk of AVF failure was associated with presence of a positive history of hypertension; in other words, positive history of hypertension has an adverse effect on AVF failure and Hypertensive HD patients have more maturated AVF.”

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References

  1. Kim JU, Kim M, Kim S, Nguyen TT, Kim E, Lee S, et al. Dendritic cell dysfunction in patients with end-stage renal disease. Immune Netw. 2017;17:152–62.

    Article  Google Scholar 

  2. Mihajlovic M, Heuvel LP, Hoenderop JG, Jansen J, Wilmer MJ, Westheim AJF, et al. Allostimulatory capacity of conditionally immortalized proximal tubule cell lines for bioartificial kidney application. Nat Sci Rep. 2017;7:7103.

    Article  Google Scholar 

  3. Webster AC, Nagler EV, Morton RL, Masson P. Chronic kidney disease. Lancet. 2017;389:1238–52.

    Article  Google Scholar 

  4. Borzou SR, Mahdipour F, Oshvandi K, Salavati M, Alimohammadi N. Effect of mealtime during hemodialysis on patients’ complications. J Caring Sci. 2016;5:277–86.

    Article  Google Scholar 

  5. Mitra S, Mitsides N. Technical aspects of hemodialysis. In: Magee CC, Tucker JK, Singh AK, editors. Core concepts in dialysis and continuous therapies. 2nd Vol. New York, NY:Springer New York LLC. 2016, pp. 15–26..

  6. Santoro D, Benedetto F, Mondello P, Pipitò N, Barillà D, Spinelli F, et al. Vascular access for hemodialysis: current perspectives. Dovepress Int J Nephrol Renov Dis. 2014;7:281–94.

    Article  Google Scholar 

  7. Stolic R. Most important chronic complications of arteriovenous fistulas for hemodialysis. Med Princ Pract. 2013;22:220–8.

    Article  Google Scholar 

  8. Khavanin Zadeh M, Gholipour F, Naderpour Z, Porfakharan M. Relationship between vessel diameter and time to maturation of arteriovenous fistula for hemodialysis access. Int J Nephrol. 2011;2012:942950.

    PubMed  PubMed Central  Google Scholar 

  9. Vazquez MA. Vascular access for dialysis: recent lessons and new insights. Curr Opin Nephrol Hypertens. 2009;18:116–21.

    Article  Google Scholar 

  10. Feldman HI, Kobrin S, Wasserstein A. Hemodialysis vascular access morbidity. J Am Soc Nephrol. 1996;7:523–35.

    CAS  PubMed  Google Scholar 

  11. Roy-Chaudhury P, Kelly BS, Zhang J, Narayana A, Desai P, Melhem M, et al. Hemodialysis vascular access dysfunction: from pathophysiology to novel therapies. Blood Purif. 2003;21:99–110.

    Article  Google Scholar 

  12. Zarjou A, Agarwal A. Superoxide in AVF dysfunction: a new target for intervention. Am J Physiol Ren Physiol. 2012;303:F1599–F1600.

    Article  CAS  Google Scholar 

  13. Rezapour M, Taran S, Parast MB, Zadeh MK. The impact of vascular diameter ratio on hemodialysis maturation time: evidence from data mining approaches and thermodynamics law. Med J Islam Repub Iran. 2016;30:359 www.ncbi.nlm.nih.gov/pmc/articles/PMC4934486/

    PubMed  PubMed Central  Google Scholar 

  14. Sepehri MM., Khavaninzadeh M., Rezapour M and Teimourpour, B. A data mining approach to fistula surgery failure analysis in hemodialysis patients. Proceedings of 2011 18th Iranian Conference of Biomedical Engineering (ICBME). Tehran, Iran: IEEE. 2011; pp. 21–26.

  15. Rezapour M, Khavanin Zadeh M, and Sepehri MM (2013). Implementation of predictive data mining techniques for identifying risk factors of early AVF failure in hemodialysis patients. Comput Math Meth Med. 2013; 2013:830745 https://doi.org/10.1155/2013/830745

    Article  Google Scholar 

  16. Rezapour M, Khavanin Zadeh M. Association between non-matured arteriovenus fistula and blood pressure in hemodialysis patients. Med J Islam Repub Iran. 2014;28:144 http://www.ncbi.nlm.nih.gov/pubmed/25695002

    PubMed  PubMed Central  Google Scholar 

  17. Khavanin Zadeh M, Rezapour M, Sepehri MM. Data mining performance in identifying the risk factors of early arteriovenous fistula failure in hemodialysis patients. Int J Hosp Res. 2013;2:49–54. http://ijhr.iums.ac.ir/index.php/ijhr/article/view/52/116

    Google Scholar 

  18. Khavanin ZM, Gholipour F, Hadipour R. The effect of hemoglobin level on arteriovenous fistula survival in Iranian hemodialysis patients. J Vasc Access. 2008;9:133–6.

    Article  Google Scholar 

  19. Rezapour M, Payani E, Taran M, Rajabzadeh Ghatari A, Khavanin Zadeh M. Roles of triglyceride and phosphate in atherosclerosis of diabetic hemodialysis patients. Med J Islam Repub Iran. 2017;31:465–71.

    Article  Google Scholar 

  20. Valerianova A, Kudlicka J, Chytilova E, Grauova B, Krupickova Z, Malik J. Factors influencing dialysis arteriovenous graft survival. J Vasc Access. 2017;18:139.

    Article  Google Scholar 

  21. Duque JC, Tabbara M, Martinez L, Cardona J, Vazquez-Padron RI, Salman LH. Dialysis arteriovenous fistula failure and angioplasty: intimal hyperplasia and other causes of access failure. Am J Kidney Dis. 2017;69:147–51.

    Article  Google Scholar 

  22. MacRae JM, Dipchand C, Oliver M, Moist L, Lok C, Clark E, et al. Arteriovenous access failure, stenosis, and thrombosis. Can J Kidney Health Dis. 2016;3:2054358116669126.

    PubMed  PubMed Central  Google Scholar 

  23. Salimi F, Shahabi S, Talebzadeh H, Keshavarzian A, Pourfakharan M, Safaei M. Evaluation of diagnostic values of clinical assessment in determining the maturation of arteriovenous fistulas for satisfactory hemodialysis. Adv Biomed Res. 2017;6:18.

    Article  Google Scholar 

  24. Yoo DW, Yoon M, Jun HJ. Successful access rate and risk factor of vascular access surgery in arm for dialysis. Vasc Spec Int. 2014;30:33.

    Article  Google Scholar 

  25. Miller PE, Tolwani A, Luscy CP, Deierhoi MH, Bailey R, Redden DT, et al. Predictors of adequacy of arteriovenous fistulas in hemodialysis patients. Kidney Int. 1999;56:275–280.

    Article  CAS  Google Scholar 

  26. Tordoir JH, Rooyens P, Dammers R, van der Sande FM, de Haan M, Yo TI. Prospective evaluation of failure modes in autogenous radiocephalic wrist access for haemodialysis. Nephrol Dial Transplant. 2003;18:378–383.

    Article  Google Scholar 

  27. Rezapour M, Sepehri MM, Khavanin Zadeh M, Alborzi M, (2018). A new method to determine anastomosis angle configuration for arteriovenous fistula maturation. Med J Islam Repub Iran (in press).

  28. Su X, Hu J, Huang S, Ning K. Rapid comparison and correlation analysis among massive number of microbial community samples based on MDV data model. Sci Rep. 2014;4:6393.

    Article  CAS  Google Scholar 

  29. Sari F, Taşkapan H, Sığırcı A, Akpınar B. Evaluation of risk factors for arteriovenous fistula failure in patients undergoing hemodialysis. Erciyes Med J. 2016;38:12–9.

    Article  CAS  Google Scholar 

  30. Fitzgerald JT, c A, Chin AI, McVicar JP, Perez RV, Troppmann C. Outcomes of upper arm arteriovenous fistulas for maintenance hemodialysis access. Arch Surg. 2004;139:201–8.

    Article  Google Scholar 

  31. Brimble KS, Rabbat CG, Schiff D, Ingram AJ. The clinical utility of Doppler ultrasound prior to arteriovenous fistula creation. Semin Dial. 2001;14:314–7.

    Article  CAS  Google Scholar 

  32. Wong V, Ward R, Taylor J, Selvakumar S, How TV, Bakran A. Factors associated with early failure of arteriovenous fistulae for haemodialysis access. Eur J Vasc Endovasc Surg. 1996;12:207–213.

    Article  CAS  Google Scholar 

  33. Parmar J, Aslam M, Standfield N. Pre-operative radial arterial diameter predicts early failure of arteriovenous fistula (AVF) for haemodialysis. Eur J Vasc Endovasc Surg. 2007;33:113–115.

    Article  CAS  Google Scholar 

  34. Silva MB Jr, Hobson RW II, Pappas PJ, Jamil Z, Araki CT, Goldberg MC, et al. A strategy for increasing use of autogenous hemodialysis access procedures: impact of preoperative noninvasive evaluation. J Vasc Surg. 1998;27:302–308.

    Article  Google Scholar 

  35. Mendes RR, Farber MA, Marston WA, Dinwiddie LC, Keagy BA, Burnham SJ. Prediction of wrist arteriovenous fistula maturation with preoperative vein mapping with ultrasonography. J Vasc Surg. 2002;36:460–463.

    Article  Google Scholar 

  36. Huber TS, Ozaki CK, Flynn TC, Lee WA, Berceli SA, Hirneise CM, et al. Prospective validation of an algorithm to maximize native arteriovenous fistulae for chronic hemodialysis access. J Vasc Surg. 2002;36:452–459.

    Article  Google Scholar 

  37. Seeger JM, Schmidt JH, Flynn TC. Preoperative saphenous and cephalic vein mapping as an adjunct to reconstructive arterial surgery. Ann Surg. 1987;205:733.

    Article  CAS  Google Scholar 

  38. Iwatsuki K, Cardinale GJ, Spector S, Udenfriend S. Hypertension: increase of collagen biosynthesis in arteries but not in veins. Science. 1977;198:403–405.

    Article  CAS  Google Scholar 

  39. Jalil JE, Doering CW, Janicki JS, Pick R, Shroff SG, Weber KT. Fibrillar collagen and myocardial stiffness in the intact hypertrophied rat left ventricle. Circ Res. 1989;64:1041–1050.

    Article  CAS  Google Scholar 

  40. Nadar SK, Blann AD, Kamath S, Beevers DG, Lip GY. Platelet indexes in relation to target organ damage in high-risk hypertensive patients: a substudy of the Anglo-Scandinavian Cardiac Outcomes Trial (ASCOT). J Am Coll Cardiol. 2004;44:415–422.

    Article  Google Scholar 

  41. Tayebjee MH, Nadar S, Blann AD, Beevers DG, MacFadyen RJ, Lip GY. Matrix metalloproteinase-9 and tissue inhibitor of metalloproteinase-1 in hypertension and their relationship to cardiovascular risk and treatment: A substudy of the Anglo-Scandinavian Cardiac Outcomes Trial (ASCOT). Am J Hypertens. 2004;17:764–769.

    CAS  PubMed  Google Scholar 

  42. Monroy-Cuadros M, Yilmaz S, Salazar-Bañuelos A, Doig C. Risk factors associated with patency loss of hemodialysis vascular access within 6 months. Clin J Am Soc Nephrol. 2010;5:1787–92.

    Article  Google Scholar 

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Acknowledgements

This article is based on part of results extracted from Ph.D. thesis recently defended by the first author (Dr. Mohammad Rezapour) at the Department of Information Technology Management, Science and Research Branch, Islamic Azad University, Tehran, Iran, supervised by Prof. Dr. Mohammad Mehdi Sepehri and Dr. Morteza Khavanin Zadeh (MD) and advisory of Dr. Mahmood Alborzi.

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Authors and Affiliations

  1. Department of Information Technology Management, Science and Research Branch, Islamic Azad University, Tehran, Iran

    Mohammad Rezapour PhD.

  2. Iran University of Medical Sciences (IUMS), Hasheminejad Kidney Center (HKC), Tehran, Iran

    Morteza Khavanin Zadeh MD

  3. Faculty of Industrial and Systems Engineering, Tarbiat Modares University, Tehran, 1411713114, Iran

    Mohammad Mehdi Sepehri PhD

  4. Hospital Management Research Center, Iran University of Medical Sciences, Tehran, 1969714713, Iran

    Mohammad Mehdi Sepehri PhD

  5. Science and Research Branch, Islamic Azad University, Tehran, Iran

    Mahmood Alborzi PhD

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  1. Mohammad Rezapour PhD.
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Correspondence to Morteza Khavanin Zadeh MD.

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Rezapour, M., Khavanin Zadeh, M., Sepehri, M.M. et al. Less primary fistula failure in hypertensive patients. J Hum Hypertens 32, 311–318 (2018). https://doi.org/10.1038/s41371-018-0052-3

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