How to Reduce the Risk of Arteriovenous Fistula Dysfunction by Observing Prepump Arterial Pressure during Hemodialysis: A Multicenter Retrospective Study
Objective: Prepump arterial (Pa) pressure indicates the ease or difficulty with which the blood pump can draw blood from the vascular access (VA) during hemodialysis. Some studies have suggested that the absolute value of the Pa pressure to the extracorporeal blood pump flow (Qb) ratio set on the ma...
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| Veröffentlicht in: | Blood purification 2021-09, Vol.50 (6), p.800-807 |
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| container_title | Blood purification |
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| creator | Sun, Chun-Yan Zhou, Li-Fang Song, Li Lan, Li-Juan Han, Xiao-Wei Zhang, Guan-Rong Mo, Ya-Wen Zheng, Shu-Qian Chen, Ying-Gui Fu, Xia |
| description | Objective: Prepump arterial (Pa) pressure indicates the ease or difficulty with which the blood pump can draw blood from the vascular access (VA) during hemodialysis. Some studies have suggested that the absolute value of the Pa pressure to the extracorporeal blood pump flow (Qb) ratio set on the machine (|Pa/Qb|) can reflect the dysfunction of VA. This study was conducted to explore the impact of arteriovenous fistula (AVF) dysfunction and to explore the clinical reference value of |Pa/Qb|. Methods: We retrospectively identified adults who underwent hemodialysis at 3 hospitals. Data were acquired from electronic health records. We evaluated the pattern of the association between |Pa/Qb| and AVF dysfunction during 1 year using a Cox proportional hazards regression model with restricted cubic splines. Then, the patients were grouped based on the results, and hazard ratios were compared for different intervals of |Pa/Qb|. Results: A total of 490 patients were analyzed, with an average age of 55 (44, 66) years. There were a total of 85 cases of AVF dysfunction, of which 50 cases were stenosis and 35 cases were thrombosis. There was a U-shaped association between |Pa/Qb| and the risk of AVF dysfunction (p for nonlinearity |
| doi_str_mv | 10.1159/000512352 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmed_primary_33530090</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2486152583</sourcerecordid><originalsourceid>FETCH-LOGICAL-c334t-5b1574f691c740ce7baa4c77f0eb4d0dc49a430a2c2dda14995c8d4cd15e5f2b3</originalsourceid><addsrcrecordid>eNpt0ctu1DAUBmCrArVDYdE9qiyxgUWKr5MJu6GlDFKrVqVdR459UtwmcfBlqjwKb4tHM8yKlSWf7_y-HIROKDmjVFafCSGSMi7ZAZpRwWhRlVy-QjPCJC8kmS-O0JsQngihYi6rQ3TEueSEVGSG_qzcC44O34FJGnD8BfjOhmfsWrz0Ebx1axhcCvjShpg6hS-m0KZBR-sG3Ez4pgng13Z4xLcextSPuzbVbTZCSB6wSX4DVtA7kwtTsOELXuLr1EWrYcg8Hx-9CyPk3DXgnzGZ6S163aouwLvdeoweLr_dn6-Kq5vvP86XV4XmXMRCNlSWop1XVJeCaCgbpYQuy5ZAIwwxWlRKcKKYZsYoKqpK6oUR2lAJsmUNP0Yft7mjd78ThFj3NmjoOjVAfnjNxGJOJZMLnumnLdX5ssFDW4_e9spPNSX1ZhL1fhLZnu5iU9OD2ct_X5_B-y14Vv4R_B7s-z_8t_z19mEr6tG0_C9_hpuK</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2486152583</pqid></control><display><type>article</type><title>How to Reduce the Risk of Arteriovenous Fistula Dysfunction by Observing Prepump Arterial Pressure during Hemodialysis: A Multicenter Retrospective Study</title><source>MEDLINE</source><source>Karger Journals</source><creator>Sun, Chun-Yan ; Zhou, Li-Fang ; Song, Li ; Lan, Li-Juan ; Han, Xiao-Wei ; Zhang, Guan-Rong ; Mo, Ya-Wen ; Zheng, Shu-Qian ; Chen, Ying-Gui ; Fu, Xia</creator><creatorcontrib>Sun, Chun-Yan ; Zhou, Li-Fang ; Song, Li ; Lan, Li-Juan ; Han, Xiao-Wei ; Zhang, Guan-Rong ; Mo, Ya-Wen ; Zheng, Shu-Qian ; Chen, Ying-Gui ; Fu, Xia</creatorcontrib><description>Objective: Prepump arterial (Pa) pressure indicates the ease or difficulty with which the blood pump can draw blood from the vascular access (VA) during hemodialysis. Some studies have suggested that the absolute value of the Pa pressure to the extracorporeal blood pump flow (Qb) ratio set on the machine (|Pa/Qb|) can reflect the dysfunction of VA. This study was conducted to explore the impact of arteriovenous fistula (AVF) dysfunction and to explore the clinical reference value of |Pa/Qb|. Methods: We retrospectively identified adults who underwent hemodialysis at 3 hospitals. Data were acquired from electronic health records. We evaluated the pattern of the association between |Pa/Qb| and AVF dysfunction during 1 year using a Cox proportional hazards regression model with restricted cubic splines. Then, the patients were grouped based on the results, and hazard ratios were compared for different intervals of |Pa/Qb|. Results: A total of 490 patients were analyzed, with an average age of 55 (44, 66) years. There were a total of 85 cases of AVF dysfunction, of which 50 cases were stenosis and 35 cases were thrombosis. There was a U-shaped association between |Pa/Qb| and the risk of AVF dysfunction (p for nonlinearity <0.001). |Pa/Qb| values <0.30 and >0.52 increased the risk of AVF dysfunction. Compared with the group with a |Pa/Qb| value between 0.30 and 0.52, the groups with |Pa/Qb| <0.30 and |Pa/Qb| >0.52 had a 4.04-fold (p = 0.002) and 3.41-fold (p < 0.001) greater risk of AVF dysfunction, respectively. Conclusions: The appropriate range of |Pa/Qb| is between 0.30 and 0.52. When |Pa/Qb| is <0.30 or >0.52, the patient’s AVF function or Qb setting should be reevaluated to prevent subsequent failure.</description><identifier>ISSN: 0253-5068</identifier><identifier>EISSN: 1421-9735</identifier><identifier>DOI: 10.1159/000512352</identifier><identifier>PMID: 33530090</identifier><language>eng</language><publisher>Basel, Switzerland</publisher><subject>Adult ; Aged ; Arterial Pressure ; Arteriovenous Fistula - etiology ; Arteriovenous Fistula - physiopathology ; Arteriovenous Fistula - prevention & control ; Female ; Humans ; Male ; Middle Aged ; Proportional Hazards Models ; Renal Dialysis - adverse effects ; Research Article ; Retrospective Studies ; Risk ; Risk Factors</subject><ispartof>Blood purification, 2021-09, Vol.50 (6), p.800-807</ispartof><rights>2021 S. Karger AG, Basel</rights><rights>2021 S. Karger AG, Basel.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c334t-5b1574f691c740ce7baa4c77f0eb4d0dc49a430a2c2dda14995c8d4cd15e5f2b3</citedby><cites>FETCH-LOGICAL-c334t-5b1574f691c740ce7baa4c77f0eb4d0dc49a430a2c2dda14995c8d4cd15e5f2b3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,777,781,2423,27905,27906</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33530090$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Sun, Chun-Yan</creatorcontrib><creatorcontrib>Zhou, Li-Fang</creatorcontrib><creatorcontrib>Song, Li</creatorcontrib><creatorcontrib>Lan, Li-Juan</creatorcontrib><creatorcontrib>Han, Xiao-Wei</creatorcontrib><creatorcontrib>Zhang, Guan-Rong</creatorcontrib><creatorcontrib>Mo, Ya-Wen</creatorcontrib><creatorcontrib>Zheng, Shu-Qian</creatorcontrib><creatorcontrib>Chen, Ying-Gui</creatorcontrib><creatorcontrib>Fu, Xia</creatorcontrib><title>How to Reduce the Risk of Arteriovenous Fistula Dysfunction by Observing Prepump Arterial Pressure during Hemodialysis: A Multicenter Retrospective Study</title><title>Blood purification</title><addtitle>Blood Purif</addtitle><description>Objective: Prepump arterial (Pa) pressure indicates the ease or difficulty with which the blood pump can draw blood from the vascular access (VA) during hemodialysis. Some studies have suggested that the absolute value of the Pa pressure to the extracorporeal blood pump flow (Qb) ratio set on the machine (|Pa/Qb|) can reflect the dysfunction of VA. This study was conducted to explore the impact of arteriovenous fistula (AVF) dysfunction and to explore the clinical reference value of |Pa/Qb|. Methods: We retrospectively identified adults who underwent hemodialysis at 3 hospitals. Data were acquired from electronic health records. We evaluated the pattern of the association between |Pa/Qb| and AVF dysfunction during 1 year using a Cox proportional hazards regression model with restricted cubic splines. Then, the patients were grouped based on the results, and hazard ratios were compared for different intervals of |Pa/Qb|. Results: A total of 490 patients were analyzed, with an average age of 55 (44, 66) years. There were a total of 85 cases of AVF dysfunction, of which 50 cases were stenosis and 35 cases were thrombosis. There was a U-shaped association between |Pa/Qb| and the risk of AVF dysfunction (p for nonlinearity <0.001). |Pa/Qb| values <0.30 and >0.52 increased the risk of AVF dysfunction. Compared with the group with a |Pa/Qb| value between 0.30 and 0.52, the groups with |Pa/Qb| <0.30 and |Pa/Qb| >0.52 had a 4.04-fold (p = 0.002) and 3.41-fold (p < 0.001) greater risk of AVF dysfunction, respectively. Conclusions: The appropriate range of |Pa/Qb| is between 0.30 and 0.52. When |Pa/Qb| is <0.30 or >0.52, the patient’s AVF function or Qb setting should be reevaluated to prevent subsequent failure.</description><subject>Adult</subject><subject>Aged</subject><subject>Arterial Pressure</subject><subject>Arteriovenous Fistula - etiology</subject><subject>Arteriovenous Fistula - physiopathology</subject><subject>Arteriovenous Fistula - prevention & control</subject><subject>Female</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Proportional Hazards Models</subject><subject>Renal Dialysis - adverse effects</subject><subject>Research Article</subject><subject>Retrospective Studies</subject><subject>Risk</subject><subject>Risk Factors</subject><issn>0253-5068</issn><issn>1421-9735</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpt0ctu1DAUBmCrArVDYdE9qiyxgUWKr5MJu6GlDFKrVqVdR459UtwmcfBlqjwKb4tHM8yKlSWf7_y-HIROKDmjVFafCSGSMi7ZAZpRwWhRlVy-QjPCJC8kmS-O0JsQngihYi6rQ3TEueSEVGSG_qzcC44O34FJGnD8BfjOhmfsWrz0Ebx1axhcCvjShpg6hS-m0KZBR-sG3Ez4pgng13Z4xLcextSPuzbVbTZCSB6wSX4DVtA7kwtTsOELXuLr1EWrYcg8Hx-9CyPk3DXgnzGZ6S163aouwLvdeoweLr_dn6-Kq5vvP86XV4XmXMRCNlSWop1XVJeCaCgbpYQuy5ZAIwwxWlRKcKKYZsYoKqpK6oUR2lAJsmUNP0Yft7mjd78ThFj3NmjoOjVAfnjNxGJOJZMLnumnLdX5ssFDW4_e9spPNSX1ZhL1fhLZnu5iU9OD2ct_X5_B-y14Vv4R_B7s-z_8t_z19mEr6tG0_C9_hpuK</recordid><startdate>20210901</startdate><enddate>20210901</enddate><creator>Sun, Chun-Yan</creator><creator>Zhou, Li-Fang</creator><creator>Song, Li</creator><creator>Lan, Li-Juan</creator><creator>Han, Xiao-Wei</creator><creator>Zhang, Guan-Rong</creator><creator>Mo, Ya-Wen</creator><creator>Zheng, Shu-Qian</creator><creator>Chen, Ying-Gui</creator><creator>Fu, Xia</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20210901</creationdate><title>How to Reduce the Risk of Arteriovenous Fistula Dysfunction by Observing Prepump Arterial Pressure during Hemodialysis: A Multicenter Retrospective Study</title><author>Sun, Chun-Yan ; Zhou, Li-Fang ; Song, Li ; Lan, Li-Juan ; Han, Xiao-Wei ; Zhang, Guan-Rong ; Mo, Ya-Wen ; Zheng, Shu-Qian ; Chen, Ying-Gui ; Fu, Xia</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c334t-5b1574f691c740ce7baa4c77f0eb4d0dc49a430a2c2dda14995c8d4cd15e5f2b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Arterial Pressure</topic><topic>Arteriovenous Fistula - etiology</topic><topic>Arteriovenous Fistula - physiopathology</topic><topic>Arteriovenous Fistula - prevention & control</topic><topic>Female</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Proportional Hazards Models</topic><topic>Renal Dialysis - adverse effects</topic><topic>Research Article</topic><topic>Retrospective Studies</topic><topic>Risk</topic><topic>Risk Factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Sun, Chun-Yan</creatorcontrib><creatorcontrib>Zhou, Li-Fang</creatorcontrib><creatorcontrib>Song, Li</creatorcontrib><creatorcontrib>Lan, Li-Juan</creatorcontrib><creatorcontrib>Han, Xiao-Wei</creatorcontrib><creatorcontrib>Zhang, Guan-Rong</creatorcontrib><creatorcontrib>Mo, Ya-Wen</creatorcontrib><creatorcontrib>Zheng, Shu-Qian</creatorcontrib><creatorcontrib>Chen, Ying-Gui</creatorcontrib><creatorcontrib>Fu, Xia</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Blood purification</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Sun, Chun-Yan</au><au>Zhou, Li-Fang</au><au>Song, Li</au><au>Lan, Li-Juan</au><au>Han, Xiao-Wei</au><au>Zhang, Guan-Rong</au><au>Mo, Ya-Wen</au><au>Zheng, Shu-Qian</au><au>Chen, Ying-Gui</au><au>Fu, Xia</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>How to Reduce the Risk of Arteriovenous Fistula Dysfunction by Observing Prepump Arterial Pressure during Hemodialysis: A Multicenter Retrospective Study</atitle><jtitle>Blood purification</jtitle><addtitle>Blood Purif</addtitle><date>2021-09-01</date><risdate>2021</risdate><volume>50</volume><issue>6</issue><spage>800</spage><epage>807</epage><pages>800-807</pages><issn>0253-5068</issn><eissn>1421-9735</eissn><abstract>Objective: Prepump arterial (Pa) pressure indicates the ease or difficulty with which the blood pump can draw blood from the vascular access (VA) during hemodialysis. Some studies have suggested that the absolute value of the Pa pressure to the extracorporeal blood pump flow (Qb) ratio set on the machine (|Pa/Qb|) can reflect the dysfunction of VA. This study was conducted to explore the impact of arteriovenous fistula (AVF) dysfunction and to explore the clinical reference value of |Pa/Qb|. Methods: We retrospectively identified adults who underwent hemodialysis at 3 hospitals. Data were acquired from electronic health records. We evaluated the pattern of the association between |Pa/Qb| and AVF dysfunction during 1 year using a Cox proportional hazards regression model with restricted cubic splines. Then, the patients were grouped based on the results, and hazard ratios were compared for different intervals of |Pa/Qb|. Results: A total of 490 patients were analyzed, with an average age of 55 (44, 66) years. There were a total of 85 cases of AVF dysfunction, of which 50 cases were stenosis and 35 cases were thrombosis. There was a U-shaped association between |Pa/Qb| and the risk of AVF dysfunction (p for nonlinearity <0.001). |Pa/Qb| values <0.30 and >0.52 increased the risk of AVF dysfunction. Compared with the group with a |Pa/Qb| value between 0.30 and 0.52, the groups with |Pa/Qb| <0.30 and |Pa/Qb| >0.52 had a 4.04-fold (p = 0.002) and 3.41-fold (p < 0.001) greater risk of AVF dysfunction, respectively. Conclusions: The appropriate range of |Pa/Qb| is between 0.30 and 0.52. When |Pa/Qb| is <0.30 or >0.52, the patient’s AVF function or Qb setting should be reevaluated to prevent subsequent failure.</abstract><cop>Basel, Switzerland</cop><pmid>33530090</pmid><doi>10.1159/000512352</doi><tpages>8</tpages></addata></record> |
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| identifier | ISSN: 0253-5068 |
| ispartof | Blood purification, 2021-09, Vol.50 (6), p.800-807 |
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| source | MEDLINE; Karger Journals |
| subjects | Adult Aged Arterial Pressure Arteriovenous Fistula - etiology Arteriovenous Fistula - physiopathology Arteriovenous Fistula - prevention & control Female Humans Male Middle Aged Proportional Hazards Models Renal Dialysis - adverse effects Research Article Retrospective Studies Risk Risk Factors |
| title | How to Reduce the Risk of Arteriovenous Fistula Dysfunction by Observing Prepump Arterial Pressure during Hemodialysis: A Multicenter Retrospective Study |
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