■成熟过程中超声确定参数的时间相关变化的研究,以及对血流动力学成熟时间的评估,能够早期预测临床合格性,血液透析自体动静脉瘘(AVF)。
■这是一个观测,prospective,仅对符合AVF资格的患者进行研究,以进行访问创建,从02/2019到02/2022(ClinicalTrials.gov标识符:NCT0473687)。肱动脉直径(dBA),接入流量(FV),非增强输出静脉直径(dEV),电阻率指数(RI),和流出静脉总壁厚度(tEV),通过超声评估。在第一周每天进行测量,并在术后第14、21、30、60和90天重复测量。主要终点包括与术后前90天AVF成熟相关的流量和结构参数的连续变化记录和成熟早期预测。次要终点包括确定影响成熟的因素。
■100名参与者(平均年龄,67±6岁;76名男性)入选。平均dBA和FV在第60天(5.64±0.85mm)和90天(1.172±617mL/min)达到最大值,分别。在随访期间,第7天dBA(5.48±0.73mm)和FV(1.039±531mL/min)的值没有显著改变。指示临床功能的参数,dEV(5.82±0.90mm)和tEV(0.493±0.10mm),达到最大值的90%(6.66±1.42mm和0.526±0.11mm),第14天RI在第30天达到最小值(0.46±0.09),第2天后无明显变化(0.48±0.09,p=0.284)。确定了显着的相关性,在第7天FV和第60天dEV之间(r=0.40,p=0.0002)。FV截止值657.51mL/min,在第7天,以85%的灵敏度和100%的特异性预测成功的瘘管成熟。多变量分析确定了女性性别,年龄>75岁,糖尿病,和手腕接入作为成熟参数值下降的独立预测因子。
■血流动力学成熟在术后第一周完成,虽然AVF具有临床功能,在第二个。FV可用于成熟的早期预测。
UNASSIGNED: The
study of time-related alterations of ultrasound-determined parameters during
maturation, and the assessment of time to hemodynamic maturation, enabling early prediction of clinical eligibility, of hemodialysis autologous arteriovenous fistulae (AVF).
UNASSIGNED: This is an observational, prospective,
study of only AVF-eligible patients referred for access creation, from 02/2019 to 02/2022 (ClinicalTrials.gov identifier: NCT0473687). Brachial artery diameter (dBA), access flow volume (FV), non-augmented efferent vein diameter (dEV), resistivity index (RI), and efferent vein total wall thickness (tEV), were assessed by ultrasound. Measurements were conducted daily in the first week and repeated on days 14, 21, 30, 60, and 90, postoperatively. The primary endpoint included the documentation of serial changes of flow and structural parameters related to AVF maturation in the first 90 days of the post-operative period and
maturation early prediction. Secondary endpoints included the determination of factors affecting
maturation.
UNASSIGNED: One hundred one participants (mean age, 67 ± 6 years; 76 males) were enrolled. Average dBA and FV reached maximum on day 60 (5.64 ± 0.85 mm) and 90 (1.172 ± 617 mL/min), respectively. Day 7 values of dBA (5.48 ± 0.73 mm) and FV (1.039 ± 531 mL/min) did not alter significantly during the follow-up period. Parameters indicative of clinical functionality, dEV (5.82 ± 0.90 mm) and tEV (0.493 ± 0.10 mm), reached approximately 90% of maximum (6.66 ± 1.42 mm and 0.526 ± 0.11 mm), by day 14. RI reached minimum on day 30 (0.46 ± 0.09), without significant changes after day 2 (0.48 ± 0.09, p = 0.284). A significant correlation was identified, between day 7 FV and day 60 dEV (r = 0.40, p = 0.0002). A FV cut-off value ⩾657.51 mL/min, on day 7, predicted successful fistula maturation with 85% sensitivity and 100% specificity. Multivariate analysis identified female gender, age >75, diabetes, and wrist access as independent predictors of decreased values of maturation parameters.
UNASSIGNED: Hemodynamic maturation is completed by the first postoperative week, while AVF is clinically functional, by the second. FV can be used for early prediction of
maturation.