Analysis Of Factors For Arteriovenous Graft Dysfunction And Predictive Value Of Platelet Distribution Width On Arteriovenous Graft Dysfunction In Hemodialysis Patients

Analysis of factors for Arteriovenous Graft Dysfunction in Hemodialysis PatientsBackground and purpose:To explore the factors affecting the dysfunction of arteriovenous graft(AVG)in hemodialysis(HD)patients,and to provide a basis for predicting the risk of dysfunction and prolonging the service time.Methods:Retrospective analysis was performed on the clinical and follow-up data of patients who underwent arteriovenous graft surgery in our center from January 2013 to September 2018.The factors of AVG dysfunction were determined by statistical methods.Results:A total of 139 patients were enrolled,and 83 patients(59.7%)developed AVG dysfunction within 24 months.The results of univariate analysis suggested that age,mean platelet volume(MPV),platelet distribution width(PDW)and platelet-larger cell ratio(P-LCR)levels were related to AVG dysfunction(all P<0.05).Multivariate Cox proportional risk regression analysis showed that high MPV(MPV>10.1,HR=6.501,95%CI 1.916-22.054,P=0.003),high PDW(PDW>11.4,HR=3.625,95%CI 1.957-6.714,P<0.001),low P-LCR(P-LCR>24.8,HR=0.145,95%CI 0.045-0.470,P=0.001)were all risk factors for AVG dysfunction.The establishment of a functional prediction equation based on the above factors has a certain value in predicting the risk of AVG dysfunction in HD patients(likelihood ratio test:χ2=49.360,P<0.001).Conclusion:There are multiple factors that affect AVG dysfunction in HD patients,among which mean MPV,PDW and P-LCR levels may be risk factors for dysfunction.Preoperative examination or postoperative comprehensive review of these factors during the follow-up period has certain directive significance for the prevention of AVG dysfunction.Platelet Distribution Width Predicts Arteriovenous Graft Dysfunction in Hemodialysis PatientsBackground and purpose:To explore the relationship between platelet distribution width(PDW)and arteriovenous graft(AVG)dysfunction,and to find new indicators for predicting risk of AVG dysfunction.Methods:Clinical and follow-up data of patients who underwent arteriovenous graft surgery in our center from January 2013 to January 2019 were retrospectively analyzed,and the relationship between PDW and AVG dysfunction was analyzed by statistical methods.Results:A total of 196 patients were enrolled,the median PDW was 10.6 fL(9.6,12.1),and four groups were designed according to PDW quartiles.112 patients(57%)developed AVG dysfunction within 24 months.The incidence of AVG dysfunction was higher in patients with the highest PDW:83%(45 events),58%(26 events),44%(21 events),and 41%(21 events),respectively,for the fourth,third,second,and first quartiles(P<0.001).Multivariate Cox analysis confirmed that PDW is an independent risk factor for AVG dysfunction(HR=2.071,95%CI 1.215-3.528,P=0.007).Conclusion:AVG dysfunction is predicted by PDW level.Patients with high PDW level are at increased risk of AVG dysfunction.