Effects of cardiovascular medications on primary patency of hemodialysis arteriovenous fistula
While the patency of vascular access is essential for hemodialysis patients, optimal pharmaceutical treatment to maintain arteriovenous fistula (AVF) patency remains lacking. As cardiovascular diseases are highly prevalent in patients with end-stage renal disease, various cardiovascular medications...
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| Veröffentlicht in: | Scientific reports 2020-07, Vol.10 (1), p.12135, Article 12135 |
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| creator | Chang, Te-I. Chen, Cheng-Hsien Hsieh, Hui-Ling Chen, Chun-You Hsu, Shih-Chang Cheng, Ho-Shun Huang, Wen-Cheng Sue, Yuh-Mou Hsu, Yung-Ho Lin, Feng-Yen Shih, Chun-Ming Lin, Shing-Jong Huang, Po-Hsun Liu, Chung-Te |
| description | While the patency of vascular access is essential for hemodialysis patients, optimal pharmaceutical treatment to maintain arteriovenous fistula (AVF) patency remains lacking. As cardiovascular diseases are highly prevalent in patients with end-stage renal disease, various cardiovascular medications have also been used to maintain AVF patency. However, previous studies revealed inconsistent therapeutic effects and a comprehensive evaluation of this issue is needed. The present retrospective, longitudinal cohort study included patients receiving successful AVF creation. The evaluated cardiovascular medications included antiplatelet agents, antihypertensive agents, nitrates and nitrites, statins, dipyridamole, and pentoxifylline. The outcome was AVF primary patency. All laboratory data and medication profiles were recorded at baseline and followed at 3-month interval, until the end of the 2-year study period. Cox proportional regression model with time-dependent covariates was used to evaluate the risk for AVF patency loss. A total of 349 patients were included in the present study, in which 57% were men and the mean age was 65 ± 14 years. Among the included patients, 40% used antiplatelet agents, 27% used dipyridamole and 36% used statins at baseline. Of all the evaluated cardiovascular medications, only dipyridamole showed significant association with a higher risk for loss of AVF patency. To evaluate the effect of combination of antiplatelet agents and dipyridamole, the patients were classified into four groups, I: combine use of antiplatelet agents and dipyridamole, II: antiplatelet only, III: dipyridamole only; IV: none of both were used. Of the four groups, group IV exhibited highest AVF patency (52.4%), which was followed by group III (42.7%), group II (40%), and group I (28.6%), respectively. Compared with group IV, only group I showed a significantly higher risk for AVF patency loss. None of the cardiovascular medications evaluated in the present study showed a beneficial effect on AVF patency. Furthermore, dipyridamole showed an association with a higher risk of AVF patency loss. We do not suggest a beneficial effect of dipyridamole on maintaining AVF patency, particularly in combination with antiplatelet agents. |
| doi_str_mv | 10.1038/s41598-020-69019-6 |
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As cardiovascular diseases are highly prevalent in patients with end-stage renal disease, various cardiovascular medications have also been used to maintain AVF patency. However, previous studies revealed inconsistent therapeutic effects and a comprehensive evaluation of this issue is needed. The present retrospective, longitudinal cohort study included patients receiving successful AVF creation. The evaluated cardiovascular medications included antiplatelet agents, antihypertensive agents, nitrates and nitrites, statins, dipyridamole, and pentoxifylline. The outcome was AVF primary patency. All laboratory data and medication profiles were recorded at baseline and followed at 3-month interval, until the end of the 2-year study period. Cox proportional regression model with time-dependent covariates was used to evaluate the risk for AVF patency loss. A total of 349 patients were included in the present study, in which 57% were men and the mean age was 65 ± 14 years. Among the included patients, 40% used antiplatelet agents, 27% used dipyridamole and 36% used statins at baseline. Of all the evaluated cardiovascular medications, only dipyridamole showed significant association with a higher risk for loss of AVF patency. To evaluate the effect of combination of antiplatelet agents and dipyridamole, the patients were classified into four groups, I: combine use of antiplatelet agents and dipyridamole, II: antiplatelet only, III: dipyridamole only; IV: none of both were used. Of the four groups, group IV exhibited highest AVF patency (52.4%), which was followed by group III (42.7%), group II (40%), and group I (28.6%), respectively. Compared with group IV, only group I showed a significantly higher risk for AVF patency loss. None of the cardiovascular medications evaluated in the present study showed a beneficial effect on AVF patency. Furthermore, dipyridamole showed an association with a higher risk of AVF patency loss. We do not suggest a beneficial effect of dipyridamole on maintaining AVF patency, particularly in combination with antiplatelet agents.</description><identifier>ISSN: 2045-2322</identifier><identifier>EISSN: 2045-2322</identifier><identifier>DOI: 10.1038/s41598-020-69019-6</identifier><identifier>PMID: 32699337</identifier><language>eng</language><publisher>London: Nature Publishing Group UK</publisher><subject>692/308/409 ; 692/700/565/1950/1544 ; Aged ; Antihypertensives ; Arteriovenous Fistula - diagnosis ; Arteriovenous Fistula - etiology ; Cardiovascular diseases ; Coronary Artery Disease - drug therapy ; Dipyridamole ; Dipyridamole - adverse effects ; Dipyridamole - pharmacology ; Dipyridamole - therapeutic use ; Drug Therapy, Combination ; End-stage renal disease ; Female ; Fistula ; Fistulae ; Hemodialysis ; Humanities and Social Sciences ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors - adverse effects ; Hydroxymethylglutaryl-CoA Reductase Inhibitors - pharmacology ; Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use ; Kidney diseases ; Kidney Failure, Chronic - pathology ; Kidney Failure, Chronic - therapy ; Longitudinal Studies ; Male ; Middle Aged ; multidisciplinary ; Nitrates ; Nitrites ; Platelet Aggregation Inhibitors - adverse effects ; Platelet Aggregation Inhibitors - pharmacology ; Platelet Aggregation Inhibitors - therapeutic use ; Proportional Hazards Models ; Renal Dialysis ; Retrospective Studies ; Risk Factors ; Science ; Science (multidisciplinary) ; Statins ; Vascular Patency - drug effects</subject><ispartof>Scientific reports, 2020-07, Vol.10 (1), p.12135, Article 12135</ispartof><rights>The Author(s) 2020</rights><rights>The Author(s) 2020. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c474t-2ff6870932cade0e309c0fe9e140615adc987a03cf054ac6ae9185a04588dea33</citedby><cites>FETCH-LOGICAL-c474t-2ff6870932cade0e309c0fe9e140615adc987a03cf054ac6ae9185a04588dea33</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7376157/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7376157/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,27901,27902,41096,42165,51551,53766,53768</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32699337$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Chang, Te-I.</creatorcontrib><creatorcontrib>Chen, Cheng-Hsien</creatorcontrib><creatorcontrib>Hsieh, Hui-Ling</creatorcontrib><creatorcontrib>Chen, Chun-You</creatorcontrib><creatorcontrib>Hsu, Shih-Chang</creatorcontrib><creatorcontrib>Cheng, Ho-Shun</creatorcontrib><creatorcontrib>Huang, Wen-Cheng</creatorcontrib><creatorcontrib>Sue, Yuh-Mou</creatorcontrib><creatorcontrib>Hsu, Yung-Ho</creatorcontrib><creatorcontrib>Lin, Feng-Yen</creatorcontrib><creatorcontrib>Shih, Chun-Ming</creatorcontrib><creatorcontrib>Lin, Shing-Jong</creatorcontrib><creatorcontrib>Huang, Po-Hsun</creatorcontrib><creatorcontrib>Liu, Chung-Te</creatorcontrib><title>Effects of cardiovascular medications on primary patency of hemodialysis arteriovenous fistula</title><title>Scientific reports</title><addtitle>Sci Rep</addtitle><addtitle>Sci Rep</addtitle><description>While the patency of vascular access is essential for hemodialysis patients, optimal pharmaceutical treatment to maintain arteriovenous fistula (AVF) patency remains lacking. As cardiovascular diseases are highly prevalent in patients with end-stage renal disease, various cardiovascular medications have also been used to maintain AVF patency. However, previous studies revealed inconsistent therapeutic effects and a comprehensive evaluation of this issue is needed. The present retrospective, longitudinal cohort study included patients receiving successful AVF creation. The evaluated cardiovascular medications included antiplatelet agents, antihypertensive agents, nitrates and nitrites, statins, dipyridamole, and pentoxifylline. The outcome was AVF primary patency. All laboratory data and medication profiles were recorded at baseline and followed at 3-month interval, until the end of the 2-year study period. Cox proportional regression model with time-dependent covariates was used to evaluate the risk for AVF patency loss. A total of 349 patients were included in the present study, in which 57% were men and the mean age was 65 ± 14 years. Among the included patients, 40% used antiplatelet agents, 27% used dipyridamole and 36% used statins at baseline. Of all the evaluated cardiovascular medications, only dipyridamole showed significant association with a higher risk for loss of AVF patency. To evaluate the effect of combination of antiplatelet agents and dipyridamole, the patients were classified into four groups, I: combine use of antiplatelet agents and dipyridamole, II: antiplatelet only, III: dipyridamole only; IV: none of both were used. Of the four groups, group IV exhibited highest AVF patency (52.4%), which was followed by group III (42.7%), group II (40%), and group I (28.6%), respectively. Compared with group IV, only group I showed a significantly higher risk for AVF patency loss. None of the cardiovascular medications evaluated in the present study showed a beneficial effect on AVF patency. Furthermore, dipyridamole showed an association with a higher risk of AVF patency loss. We do not suggest a beneficial effect of dipyridamole on maintaining AVF patency, particularly in combination with antiplatelet agents.</description><subject>692/308/409</subject><subject>692/700/565/1950/1544</subject><subject>Aged</subject><subject>Antihypertensives</subject><subject>Arteriovenous Fistula - diagnosis</subject><subject>Arteriovenous Fistula - etiology</subject><subject>Cardiovascular diseases</subject><subject>Coronary Artery Disease - drug therapy</subject><subject>Dipyridamole</subject><subject>Dipyridamole - adverse effects</subject><subject>Dipyridamole - pharmacology</subject><subject>Dipyridamole - therapeutic use</subject><subject>Drug Therapy, Combination</subject><subject>End-stage renal disease</subject><subject>Female</subject><subject>Fistula</subject><subject>Fistulae</subject><subject>Hemodialysis</subject><subject>Humanities and Social Sciences</subject><subject>Humans</subject><subject>Hydroxymethylglutaryl-CoA Reductase Inhibitors - adverse effects</subject><subject>Hydroxymethylglutaryl-CoA Reductase Inhibitors - pharmacology</subject><subject>Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use</subject><subject>Kidney diseases</subject><subject>Kidney Failure, Chronic - pathology</subject><subject>Kidney Failure, Chronic - therapy</subject><subject>Longitudinal Studies</subject><subject>Male</subject><subject>Middle Aged</subject><subject>multidisciplinary</subject><subject>Nitrates</subject><subject>Nitrites</subject><subject>Platelet Aggregation Inhibitors - adverse effects</subject><subject>Platelet Aggregation Inhibitors - pharmacology</subject><subject>Platelet Aggregation Inhibitors - therapeutic use</subject><subject>Proportional Hazards Models</subject><subject>Renal Dialysis</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Science</subject><subject>Science (multidisciplinary)</subject><subject>Statins</subject><subject>Vascular Patency - drug effects</subject><issn>2045-2322</issn><issn>2045-2322</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp9UctKxDAUDaKo6PyACym4rt4kbdpsBBFfILjRreGa3mhkphmTVpi_NzrjqBuzSeA8w2HsgMMxB9mepIrXui1BQKk0cF2qDbYroKpLIYXY_PXeYZOUXiGfWuiK6222I4XSWspmlz1eOEd2SEVwhcXY-fCOyY5TjMWMOm9x8KHPaF_Mo59hXBRzHKi3i0_BC81C53G6SD4VGAeKWU59GFPhfBqyyz7bcjhNNFnde-zh8uL-_Lq8vbu6OT-7LW3VVEMpnFNtA1oKix0BSdAWHGniFSheY2d12yBI66Cu0Cokzdsa8w_btiOUco-dLn3n41PubakfIk7NqrMJ6M1fpPcv5jm8m0Y2OaDJBkcrgxjeRkqDeQ1j7HNnIyqhAFSt68wSS5aNIaVIbp3AwXzOYpazmDyL-ZrFqCw6_N1tLfkeIRPkkpAy1D9T_Mn-x_YDuoSbTA</recordid><startdate>20200722</startdate><enddate>20200722</enddate><creator>Chang, Te-I.</creator><creator>Chen, Cheng-Hsien</creator><creator>Hsieh, Hui-Ling</creator><creator>Chen, Chun-You</creator><creator>Hsu, Shih-Chang</creator><creator>Cheng, Ho-Shun</creator><creator>Huang, Wen-Cheng</creator><creator>Sue, Yuh-Mou</creator><creator>Hsu, Yung-Ho</creator><creator>Lin, Feng-Yen</creator><creator>Shih, Chun-Ming</creator><creator>Lin, Shing-Jong</creator><creator>Huang, Po-Hsun</creator><creator>Liu, Chung-Te</creator><general>Nature Publishing Group UK</general><general>Nature Publishing Group</general><scope>C6C</scope><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>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88A</scope><scope>88E</scope><scope>88I</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M2P</scope><scope>M7P</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>Q9U</scope><scope>5PM</scope></search><sort><creationdate>20200722</creationdate><title>Effects of cardiovascular medications on primary patency of hemodialysis arteriovenous fistula</title><author>Chang, Te-I. ; Chen, Cheng-Hsien ; Hsieh, Hui-Ling ; Chen, Chun-You ; Hsu, Shih-Chang ; Cheng, Ho-Shun ; Huang, Wen-Cheng ; Sue, Yuh-Mou ; Hsu, Yung-Ho ; Lin, Feng-Yen ; Shih, Chun-Ming ; Lin, Shing-Jong ; Huang, Po-Hsun ; Liu, Chung-Te</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c474t-2ff6870932cade0e309c0fe9e140615adc987a03cf054ac6ae9185a04588dea33</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>692/308/409</topic><topic>692/700/565/1950/1544</topic><topic>Aged</topic><topic>Antihypertensives</topic><topic>Arteriovenous Fistula - diagnosis</topic><topic>Arteriovenous Fistula - etiology</topic><topic>Cardiovascular diseases</topic><topic>Coronary Artery Disease - drug therapy</topic><topic>Dipyridamole</topic><topic>Dipyridamole - adverse effects</topic><topic>Dipyridamole - pharmacology</topic><topic>Dipyridamole - therapeutic use</topic><topic>Drug Therapy, Combination</topic><topic>End-stage renal disease</topic><topic>Female</topic><topic>Fistula</topic><topic>Fistulae</topic><topic>Hemodialysis</topic><topic>Humanities and Social Sciences</topic><topic>Humans</topic><topic>Hydroxymethylglutaryl-CoA Reductase Inhibitors - adverse effects</topic><topic>Hydroxymethylglutaryl-CoA Reductase Inhibitors - pharmacology</topic><topic>Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use</topic><topic>Kidney diseases</topic><topic>Kidney Failure, Chronic - pathology</topic><topic>Kidney Failure, Chronic - therapy</topic><topic>Longitudinal Studies</topic><topic>Male</topic><topic>Middle Aged</topic><topic>multidisciplinary</topic><topic>Nitrates</topic><topic>Nitrites</topic><topic>Platelet Aggregation Inhibitors - 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As cardiovascular diseases are highly prevalent in patients with end-stage renal disease, various cardiovascular medications have also been used to maintain AVF patency. However, previous studies revealed inconsistent therapeutic effects and a comprehensive evaluation of this issue is needed. The present retrospective, longitudinal cohort study included patients receiving successful AVF creation. The evaluated cardiovascular medications included antiplatelet agents, antihypertensive agents, nitrates and nitrites, statins, dipyridamole, and pentoxifylline. The outcome was AVF primary patency. All laboratory data and medication profiles were recorded at baseline and followed at 3-month interval, until the end of the 2-year study period. Cox proportional regression model with time-dependent covariates was used to evaluate the risk for AVF patency loss. A total of 349 patients were included in the present study, in which 57% were men and the mean age was 65 ± 14 years. Among the included patients, 40% used antiplatelet agents, 27% used dipyridamole and 36% used statins at baseline. Of all the evaluated cardiovascular medications, only dipyridamole showed significant association with a higher risk for loss of AVF patency. To evaluate the effect of combination of antiplatelet agents and dipyridamole, the patients were classified into four groups, I: combine use of antiplatelet agents and dipyridamole, II: antiplatelet only, III: dipyridamole only; IV: none of both were used. Of the four groups, group IV exhibited highest AVF patency (52.4%), which was followed by group III (42.7%), group II (40%), and group I (28.6%), respectively. Compared with group IV, only group I showed a significantly higher risk for AVF patency loss. None of the cardiovascular medications evaluated in the present study showed a beneficial effect on AVF patency. Furthermore, dipyridamole showed an association with a higher risk of AVF patency loss. We do not suggest a beneficial effect of dipyridamole on maintaining AVF patency, particularly in combination with antiplatelet agents.</abstract><cop>London</cop><pub>Nature Publishing Group UK</pub><pmid>32699337</pmid><doi>10.1038/s41598-020-69019-6</doi><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; Nature Free; DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central; Alma/SFX Local Collection; Springer Nature OA/Free Journals; Free Full-Text Journals in Chemistry |
| subjects | 692/308/409 692/700/565/1950/1544 Aged Antihypertensives Arteriovenous Fistula - diagnosis Arteriovenous Fistula - etiology Cardiovascular diseases Coronary Artery Disease - drug therapy Dipyridamole Dipyridamole - adverse effects Dipyridamole - pharmacology Dipyridamole - therapeutic use Drug Therapy, Combination End-stage renal disease Female Fistula Fistulae Hemodialysis Humanities and Social Sciences Humans Hydroxymethylglutaryl-CoA Reductase Inhibitors - adverse effects Hydroxymethylglutaryl-CoA Reductase Inhibitors - pharmacology Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use Kidney diseases Kidney Failure, Chronic - pathology Kidney Failure, Chronic - therapy Longitudinal Studies Male Middle Aged multidisciplinary Nitrates Nitrites Platelet Aggregation Inhibitors - adverse effects Platelet Aggregation Inhibitors - pharmacology Platelet Aggregation Inhibitors - therapeutic use Proportional Hazards Models Renal Dialysis Retrospective Studies Risk Factors Science Science (multidisciplinary) Statins Vascular Patency - drug effects |
| title | Effects of cardiovascular medications on primary patency of hemodialysis arteriovenous fistula |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-05T10%3A30%3A16IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Effects%20of%20cardiovascular%20medications%20on%20primary%20patency%20of%20hemodialysis%20arteriovenous%20fistula&rft.jtitle=Scientific%20reports&rft.au=Chang,%20Te-I.&rft.date=2020-07-22&rft.volume=10&rft.issue=1&rft.spage=12135&rft.pages=12135-&rft.artnum=12135&rft.issn=2045-2322&rft.eissn=2045-2322&rft_id=info:doi/10.1038/s41598-020-69019-6&rft_dat=%3Cproquest_pubme%3E2426006595%3C/proquest_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2426006595&rft_id=info:pmid/32699337&rfr_iscdi=true |