Systemic microvascular endothelial function with arteriovenous fistula creation in chronic kidney disease

Autor: Siew Cheng Chai, Zulkefli Sanip, Aida Hanum Ghulam Rasool, Amran Ahmed Shokri, Ahmad Sukari Halim, Arman Zaharil Mat Saad, Wan Azman Wan Sulaiman
Jazyk: angličtina
Rok vydání: 2022
Předmět:
Zdroj: Journal of Research in Medical Sciences, Vol 27, Iss 1, Pp 46-46 (2022)
Druh dokumentu: article
ISSN: 1735-1995
1735-7136
DOI: 10.4103/jrms.JRMS_908_19
Popis: Background: This study aimed to determine changes in microvascular endothelial function with upper arm arteriovenous fistula (AVF) creation and maturation in patients with chronic kidney disease (CKD). Materials and Methods: This prospective cross-sectional study was performed at Hospital Universiti Sains Malaysia, a tertiary hospital in Malaysia. Forty CKD patients (stage 4–5) who were scheduled for elective AVF creation over the upper extremity for maintenance hemodialysis were recruited using convenience sampling method. Microvascular endothelial-dependent vasodilation was measured using laser Doppler flowmetry and the process of iontophoresis preoperatively and postoperatively at weeks 2 and 6. Fistula maturation was assessed at week 6. Results: Thirty-two patients had successful AVF maturation. Endothelial-dependent vasodilation (acetylcholine (Ach)%) was higher (246.48 [standard deviation (SD) 209.38] vs. 104.95 [SD 43.29], P = 0.001) while systolic blood pressure was lower (142.25 [SD 21.50] vs. 162.25 [SD 13.26], P = 0.017) in this group as compared to unsuccessful AVF group. No significant changes were seen in overall microvascular endothelial-dependent vasodilation during the 6-week study period (day 0, 246.48 [SD 209.38]; week 2, 201.14 [SD 198.19]; and week 6, 203.53 [SD 145.89]). Conclusion: Upper arm AVF creation does not affect microvascular endothelial function up to 6 weeks post operation and may not contribute to the success of AVF maturation. However, the lower microvascular endothelial-dependent vasodilation and higher systolic blood pressure in unsuccessful AVF subjects need to be further studied.
Databáze: Directory of Open Access Journals
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