#6934 INFLAMMATORY STATUS PRIOR TO THE CREATION OF ARTERIOVENOUS FISTULAS FOR HEMODIALYSIS: IS IT DETERMINING?

Abstract

Abstract Background and Aims Clinical practice guidelines recommend an arteriovenous fistula (AVIF) as the preferred vascular access for hemodialysis and is associated with a lower incidence of morbidity and mortality. However, primary vascular access (VA) failure is not uncommon. Low-grade inflammation is present in ERCT. We identified the inflammatory parameters that influence the primary patency of the vascular access for hemodialysis. Method Cross-sectional study; We included all VAs made between October 2009 and April 2022. We evaluated the initial performance after the creation of the VAs. Demographic variables (age, sex), CKD etiology, and associated comorbidity were collected. Statistical analysis with SPSS 25.0. Categorical variables are expressed as percentages and compared using the Chi2 test. Quantitative variables are expressed as mean ± standard deviation and the t-student test was used to compare them. Statistical significance for a value of p<0.05. Results 712 VA performed in 546 patients were reviewed between October 2009 and April 2022. 617 autologous VA (86.7%) and 95 prosthetic VA (13.3%) were performed. The mean age of the patients was 65.4 ± 14.1 years and 67.4% were male. The most frequent etiology of CKD was diabetic nephropathy (30.5%), followed by unknown (17.3%) and glomerulonephritis (16.4%). 91.4% of the patients presented arterial hypertension (HTA), diabetes mellitus (DM) 47.5%. 72.6% of the VA presented primary permeability. In the univariate analysis using Chi2 and T student, AHT (p<0.001), treatment with statins (p<0.001), antiaggregation (p<0.001), normal fibrinogen levels (p = 0.003), and CRP (p<0.001) reached statistical significance. = 0.039). When recoding the PCR in relation to its normal values, the pathological levels were associated with primary failure after the creation of AVFs. Conclusion In our study, inflammatory states with elevated CRP and ferritin were associated with primary failure in initial functioning after the creation of AVFs. On the contrary, arterial hypertension and treatment with statins prior to the creation of AVFs are associated with their primary permeability.