Impact of Ischemic Heart Disease on Early Access Failure in Nondiabetic Hemodialysis Patients
Abstract:Atherosclerotic lesion of coronary artery frequently accompanies intimal hyperplasia of radial artery. We have reported that the lesion of radial artery (intimal hyperplasia) in hemodialysis (HD) patients is associated with early access failure (EAF) as well as ischemic heart disease (IHD) (Am J Kidney Dis. 2003; 41: 422–428). Objective:
This study was designed to determine the impact of IHD on the EAF in nondiabetic HD patients. Methods:
This study enrolled 125 nondiabetic HD patients who received radiocephalic arteriovenous fistula operation for the first time. We evaluated IHD before the operation through clinical symptoms and electrocardiography and then investigated EAF within 1 year after the operation. We analyzed the access patency rates between the patients with and without IHD, using Kaplan–Meier method and log-rank test. Multiple regression analysis was performed to identify independent risk factors of the EAF. Results:
The mean age of the patients was 48 ± 14 years, and the number of females was 54 (43.2%). Of the total 125 patients, 19 patients (15.4%) had IHD before the operation. The EAF developed in 23 patients (18.4%) within 1 years after the operation. The access patency rate in the patients with IHD was lower than that in the patients without IHD (39.7 vs. 88.3%, p < 0.001). IHD and old age were independent risk factors of the EAF in nondiabetic HD patients. But sex, smoking history, hypertension, and the levels of hemoglobin, serum creatinine, albumin, and total cholesterol checked before the operation were not associated with the EAF. Conclusion:
This study suggests that IHD is closely associated with EAF in nondiabetic HD patients.
Document Type: Research Article
Affiliations: Department of Internal Medicine, The Catholic University of Korea, Seoul, Korea.
Publication date: 2004-01-01