Less primary fistula failure in hypertensive patients

• Published in: Journal of human hypertension 2018-04, Vol.32 (4), p.311-318
• Main Authors: Rezapour, Mohammad, Khavanin Zadeh, Morteza, Sepehri, Mohammad Mehdi, Alborzi, Mahmood
• Format: Article
• Language: English
• Subjects: 13/107; 631/443; 692/499; Adult; Aged; Anastomosis, Surgical - adverse effects; Blood vessels; Care and treatment; Chronic kidney failure; Complications and side effects; Correspondence; Data processing; Epidemiology; Failure; Female; Fistula; Fistula, Arteriovenous; Fistulae; Health Administration; Hemodialysis; Humans; Hypertension; Kidney Failure, Chronic - complications; Kidney Failure, Chronic - therapy; Kidney transplantation; Male; Medicine; Medicine & Public Health; Middle Aged; Morbidity; Patient outcomes; Public Health; Surgery; Vascular Access Devices - adverse effects
• ISSN: 0950-9240; 1476-5527
• DOI: 10.1038/s41371-018-0052-3

End stage renal disease (ESRD) patients suffer from advanced renal diseases and actually nonfunctioning kidneys, and need kidney transplantation or dialysis. Hemodialysis (HD) is the most used method and requires a vascular access (VA). Arteriovenous fistula (AVF) is the first choice of VA over the world for having least morbidity and mortality. Despite the wide-spread use of AVFs, the rate of AVF failures are notable. Detecting the factors that cause AVF failure can reduce repeating VA surgeries and hospitalization of ESRD patients. Present research studies 480 Iranian HD patients who underwent AVF surgery from 2010 to 2017 and aged 18–90 years old, using data mining techniques. (i) The AVF failure rate was equal to 8.96%, such that AVF failure has occurred in 3.54% and 5.52% of HD patient with and without hypertension, respectively. (ii) The rate of non-failure AVF in hypertensive patients is 61.46%, whereas the same rate for patients with negative history of hypertension reaches to 29.58%. (iii) Hypertension has a significant inverse association with AVF failure (Spearman’s ρ  = −0.160, P -value ≤ 0.005). (iv) The decision tree (with accuracy rate = 92.24%) shows less AVF failure in hypertsensive patients (5.53%) comparing with non-hypertensive patients (15.09%). (v) The AVFs with greater failure rates and non-hypertensive HD patients were clustered together. “Significantly lower risk of AVF failure was associated with presence of a positive history of hypertension; in other words, positive history of hypertension has an adverse effect on AVF failure and Hypertensive HD patients have more maturated AVF.”