Browsing by Author "Jovanovic, Aleksandar N. (56386929900)"

Introduction: Arteriovenous fistulas (AVFs) are the preferred form vascular access for hemodialysis (HD), as they have a low rate of complications and durable function. The aim of our investigation was to analyze the factors that might influence the function of AVFs. Methods: Data were taken from the computerized patient record system in the Clinic of Urology and Nephrology, Clinical Center, Kragujevac, Serbia, for a 2-year period. We analyzed patients who had requested re-creation of AVFs as a secondary procedure. During this period 112 patients, 73 (65%) men and 39 (35%) women, had AVF thromboses. All relevant clinical and laboratory parameters that could affect the function and survival of AVF were evaluated. Findings: In univariate logistic regression analysis, statistically significant predictors influencing the duration of the fistula were magnesium (P < 0.001), triglycerides (P = 0.041), smoking (P = 0.001), antiplatelet therapy (P < 0.001), and type of HD (bicarbonate vs. hemodiafiltration) (P < 0.001). In the multiple logistic regression model, high concentrations of magnesium (B = 7434; P < 0.001) and antiplatelet therapy (B - 1.042; P = 0.04) were significantly associated with the length of AVF function. Discussion: After successful establishment of an AVF, there is a compelling need to maintain fistula patency. Factors that affect functioning of the AVFs are presently under intense scrutiny. According to our results, some clinical factors may determine long term fistula duration, such as concentration of the magnesium and antiplatelet therapy. © 2017 International Society for Hemodialysis

Purpose: Magnesium insufficiency is a pro-atherogenic factor involved in endothelial dysfunction, atherosclerosis, and vascular calcification. Our aim was to examine the role of magnesium in the development of arteriovenous fistula complications in hemodialysis. Methods: This was a retrospective clinical investigation of data from 88 patients who were divided into two groups: those with and without arteriovenous fistula complications. We examined the influence of sex, demographics, and clinical and laboratory parameters. The existence of fistula stenosis was determined by measuring Doppler flow, while B-mode ultrasound was used to detect plaques and evaluate the carotid artery intima–media thickness. Results: Patients with arteriovenous fistula complications had significantly higher leukocyte counts (p = 0.03), platelet counts (p = 0.03), phosphate concentrations (p = 0.044), and alkaline phosphatase concentrations (p = 0.04). Patients without complications had significantly greater blood flow through the arteriovenous fistula (p < 0.0005), higher magnesium concentrations (p = 0.004), and a lower carotid artery intima–media thickness (p = 0.037). The magnesium level was inversely correlated with leukocyte (p = 0.028) and platelet (p = 0.016) counts. The magnesium concentration was significantly lower in patients with carotid artery plaques (p = 0.03). Multiple linear regression, using magnesium as the dependent variable in patients with arteriovenous fistula complications, indicated statistically significant correlations with platelet (p = 0.005) and leukocyte (p = 0.027) counts and carotid plaques (p = 0.045). Conclusions: Hypomagnesemia is a significant pro-atherogenic factor and an important predictor of arteriovenous fistula complications. © 2016, Springer Science+Business Media Dordrecht.