The effect of serum intact parathyroid hormone level on the maturation of autogeneous arteriovenous fistula

doi:10.3969/j.issn.1004-583X.2022.12.005

Abstract

Abstract:

Objective To investigate the effect of serum intact parathyroid hormone (iPTH) level on the maturation of autogeneous arteriovenous fistula (AVF) in patients with chronic renal failure (CRF). Methods A total of 108 patients treated with AVF angioplasty in the Nephrology Department of Sinopharm Dongfeng General Hospital from January 2019 to May 2022 were recruited. Their baseline characteristics, biochemical data, color ultrasound reports of arteries and veins of both upper limbs and those of radial artery cephalic vein fistula at 2 months postoperatively were collected. Patients were assigned into AVF maturation group and AVF malmaturation group. The influence of clinical data on the maturation of AVF was analyzed. Results Compared with patients in the AVF malmaturation group, patients in the AVF maturation group were significantly younger, and the incidence of diabetes was significantly lower (P<0.05). Moreover, the use of calcium antagonists was significantly less frequent (P<0.05). Serum iPTH and high-sensitivity C-reactive protein were significantly lower in the AVF maturation group (P<0.05). The diameter of cephalic vein was significantly larger than that of AVF malmaturation group (P<0.05). Multivariate Logistic regression analysis showed that age, high-sensitivity C-reactive protein and head vein diameter were independent risk factors for AVF maturation (all P<0.05). Conclusion Age, high sensitivity C-reactive protein and head vein diameter are independent risk factors for AVF maturation. Elevated iPTH levels are associated with poor AVF maturation.

Key words: kidney failure, chronic, serum intact parathyroid hormone, autogeneous arteriovenous fistula

CLC Number:

R692.5

Wang Pengrui, Chen Huaqian, Yang Tao, Zhao Li, Li Peng. The effect of serum intact parathyroid hormone level on the maturation of autogeneous arteriovenous fistula[J]. Clinical Focus, 2022, 37(12): 1094-1098.

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https://lchc.magtechjournal.com/EN/Y2022/V37/I12/1094

Figures/Tables 4

References 32

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组别	例数	性别(例)		年龄 (岁)	合并糖尿病 (例)	使用钙离子拮抗剂 (例)
组别	例数	男	女	年龄 (岁)	合并糖尿病 (例)	使用钙离子拮抗剂 (例)
AVF成熟组	85	52	33	57.69±13.07	32	58
AVF成熟不良组	23	14	9	67.83±11.42	15	20
统计值		χ²=0.027		t=3.382	χ²=2.407	χ²=2.129
P值		0.979		0.001	0.018	0.039

组别	例数	性别(例)		年龄 (岁)	合并糖尿病 (例)	使用钙离子拮抗剂 (例)
组别	例数	男	女	年龄 (岁)	合并糖尿病 (例)	使用钙离子拮抗剂 (例)
AVF成熟组	85	52	33	57.69±13.07	32	58
AVF成熟不良组	23	14	9	67.83±11.42	15	20
统计值		χ²=0.027		t=3.382	χ²=2.407	χ²=2.129
P值		0.979		0.001	0.018	0.039

组别	例数		iPTH (pg/ml)		hs-CRP (mg/L)		血红蛋白 (g/L)		中性粒细胞/ 淋巴细胞比值		血小板/ 淋巴细胞比值		ALB (g/L)
AVF成熟组	85		137.44±74.61		1.92±1.45		92.11±16.09		4.73±3.84		205.92±181.28		34.36±3.27
AVF成熟不良组	23		193.10±122.07		6.20±2.99		90.74±17.74		4.79±3.18		189.40±94.06		34.17±5.56
t值			2.084		6.651		-0.354		0.077		-0.421		-0.157
P值			0.047		0.000		0.724		0.939		0.675		0.876
组别		例数		血清钙(mmol/L)		血清磷(mmol/L)		TC(mmol/L)		TG(mmol/L)		LDL-C(mmol/L)
AVF成熟组		85		2.09±0.15		1.47±0.45		3.96±1.17		1.36±0.78		1.94±0.90
AVF成熟不良组		23		2.05±0.15		1.57±0.55		3.71±0.85		1.22±0.38		2.03±0.81
t值				-1.221		0.870		-0.969		-1.223		0.428
P值				0.225		0.386		0.335		0.225		0.670

组别	例数		iPTH (pg/ml)		hs-CRP (mg/L)		血红蛋白 (g/L)		中性粒细胞/ 淋巴细胞比值		血小板/ 淋巴细胞比值		ALB (g/L)
AVF成熟组	85		137.44±74.61		1.92±1.45		92.11±16.09		4.73±3.84		205.92±181.28		34.36±3.27
AVF成熟不良组	23		193.10±122.07		6.20±2.99		90.74±17.74		4.79±3.18		189.40±94.06		34.17±5.56
t值			2.084		6.651		-0.354		0.077		-0.421		-0.157
P值			0.047		0.000		0.724		0.939		0.675		0.876
组别		例数		血清钙(mmol/L)		血清磷(mmol/L)		TC(mmol/L)		TG(mmol/L)		LDL-C(mmol/L)
AVF成熟组		85		2.09±0.15		1.47±0.45		3.96±1.17		1.36±0.78		1.94±0.90
AVF成熟不良组		23		2.05±0.15		1.57±0.55		3.71±0.85		1.22±0.38		2.03±0.81
t值				-1.221		0.870		-0.969		-1.223		0.428
P值				0.225		0.386		0.335		0.225		0.670

组别	例数	头静脉内径 (mm)	肱动脉内径 (mm)	肱动脉血流量 (cm/s)	桡动脉内径 (mm)	桡动脉血流量 (cm/s)
AVF成熟组	85	2.42±0.51	4.09±0.53	71.36±22.03	2.34±0.42	58.21±16.09
AVF成熟不良组	23	2.07±0.40	3.94±0.58	66.30±13.70	2.20±0.30	53.48±14.94
t值		-3.120	-1.192	-1.046	-1.600	-1.270
P值		0.002	0.236	0.298	0.113	0.207