Influence of intradialytic systolic blood pressure changes on
arteriovenous access thrombosis in long-term hemodialysis patients
Abstract
Background: Arteriovenous access (AV) thrombosis is important and
preventable problem among chronic hemodialysis (HD) patients. On the
other hand, systolic blood pressure (SBP) alteration relates with higher
cardiovascular mortality among these patients. In this study, we
investigated the relation between SBP changes and arteriovenous access
(AV) thrombosis. Methods: 50 HD patients with thrombosis and 50 HD
patients without thrombosis were included in the study. Odds ratios and
95% confidence intervals were estimated with multivariate adjusted
logistic regression models to determine the association between
potential thrombosis-related risk factors and thrombosis risk. Results:
Elder adults, women, and patients with arteriovenous grafts, lower
intradialytic SBP and higher SBP variations during dialysis sessions had
higher incidence of AV access thrombosis. Chronic inflammation and
mineral metabolism related parameters were also found to be abnormal at
the time of AV access thrombosis. Conclusions: Close monitoring and
management of intra-dialytic hypotension, SBP variation in every
dialysis session and correction of biochemical parameters are critical
for earlier identification and prevention of AV access thrombosis in HD
patients.