Survival analysis and risk factors for arteriovenous fistula in 472 patients

Abstract

To evaluate the service life of the arteriovenous fistula (AVF) in patients with dialysis and to explore the associated factors for AVF service life. A cohort study regarding 472 cases with AVFs at the Second Xiangya Hospital from January 2009 to December 2009 was retrospectively analyzed. The AVF placement-associated primary and secondary failure rates, complications and various risk factors were examined. Kaplan-Meier survival curves and Cox proportional hazard models were used to determine the service life and associated factors. By the end of January 1st, 2014, after excluding the patients with indeterminate outcome (72 lost to follow-up; 101 died; 44 transplanted), the primary failure rate was 10.9%, the survival rate for 1, 3 or 5 years was 80.5%, 65.1% or 50.5%. The complication rate and hospitalization rate for AVF were 39.8% and 9.8%, respectively. The influential factors for AVF were diastolic hypotension (HR: 0.86; 95% CI: 0.82 to 0.89), diabetes (HR: 1.87; 95% CI: 1.32 to 3.31) and serum albumin (HR: 0.83; 95% CI: 0.74 to 0.94). The complications after AVF placement must be considered before the surgery schedule. Hypotension, diabetes and serum albumin are the main risk factors for AVF service life.