Keywords
Morbidity
Mortality
Arteriovenous fistula
Arterial hypertension
Serum creatinine
Echocardiography
How to Cite
Abstract
Background: Cardiovascular disorders constitute the first cause of morbidity and mortality in the renal transplant recipient.
Purpose: To determine the possible association between arteriovenous fistula closure and cardiovascular dysfunction in renal transplant recipients.
Methodology: Quasi-experimental study that included 116 functioning renal transplant recipients. Angioaccess was closed in 59 (experimental group) and not closed in 57 patients (comparison group).
Results: The overall mean age was 47 ±12.2 years and male sex was the most frequent; 65 (56 %). In the experimental group; clinical variables, differences, end – baseline systolic and diastolic blood pressure, serum creatinine and those measured by transthoracic echocardiography, improved with respect to the comparison group.
Conclusions: Closure of arteriovenous fistula in functioning renal transplant recipients contributes to reduce morbidity and mortality secondary to cardiovascular disorders.
References
National Kidney Foundation. K/DOQI clinical practice for chronic kidney disease: Evaluation, classification, and stratification. Am J Kidney Dis. 2002;39(supl. 1):S1-266.
Moughai S, Bashir M, Mohammed I, Abdelhaliem A, El-SantawiH, Al-Khaffaf H. High-output cardiac failure to arteriovenous fistula: a wide-based literature review. Interv Cardiol. 2020;12(4):101-5.
Yilmaz KC, Akgun AN, Keskin S, Ciftci O, Moray G, Muderrisoglu H, et al. The effect of renal transplantation on cardiac functions. Saudi J Kidney Dis Transpl. 2020;31(5):1051-6. https://doi.org/10.4103/1319-2442.301170
Bardowska K, Letachowicz K, Kami?ska D, Kusztal M, Go??biowski T, Królicki T, et al. The attitude of kidney transplant recipients towards elective arteriovenous fistula ligation. PLoS One. 2020;15(7):e0234931. https://doi.org/10.1371/journal.pone.0234931
Ikizler TA. Arteriovenous fistulas in patients with kidney transplantation. Kidney Int. 2020;97(1):20-1. https://doi.org/10.1016/j.kint.2019.09.012
Hetz P, Pirklbauer M, Müller S, Posch L, Gummerer M, Tiefenthaler M. Prophylactic ligature of AV fistula prevents high output heart failure after kidney transplantation. Am J Nephrol. 2020;51(7):511-9. https://doi.org/10.1159/000508957
Oficina Nacional de Estadística e Información. Anuario Estadístico de Cuba 2020. Capítulo 3: Población. La Habana: ONEI. https://www.presidencia.gob.cu/media/filer/public/2022/05/07/anuario_2020_ver2021_lYMhjjw.pdf
Jeong S, Kwon H, Kim JY, Kim YH, Kwon TW, Lee JB, et al. Effect of arteriovenous access closure and timing on kidney transplant recipients. PLoS One. 2019;14(12):e0226309. https://doi.org/10.1371/journal.pone.0226309
Rao NN, Dundon B, Worthley MI, Faull RJ. The impact of arteriovenous fistula for hemodialysis on the cardiovascular system. Semin Dial. 2016;29(3):214-21. https://doi.org/10.1111/sdi.12459
van Duijnhoven EC, Cheriex EC, Tordoir JH, Kooman JP, van Hooff JP. Effect of closure of the arteriovenous fistula on left ventricular dimensions in renal transplant patients. Nephrol Dial Transplant. 2001;16(2):368-72. https://doi.org/10.1093/ndt/16.2.368
James PA, Oparil S, Carter BL, Cushman WC, Dennison-Himmelfarb C, Handler J, et al. 2014 Evidence-based guideline for the management of high blood pressure in adults: report from the Panel Members Appointed to the Eighth Joint National Committee (JNC 8). JAMA. 2014;311(5):507-20. https://doi.org/10.1001/jama.2013.284427
Jehn U, Schütte-Nütgen K, Strauss M, Kunert J, Pavenstädt H, Thölking G, et al. Antihypertensive treatment in kidney transplant recipients - a current single center experience. J Clin Med. 2020;9(12):3969. https://doi.org/10.3390/jcm9123969
Mallamaci F, D'Arrigo G, Tripepi R, Leonardis D, Porto G, Testa A, et al. Office, standardize and 24 – h ambulatory blood pressure and renal function loss in renal transplant patients. J Hypertens. 2018;36(1):119-25. https://doi.org/10.1097/hjh.0000000000001530
Weekers L, Vanderweckene P, Pottel H, Castanares-Zapatero D, Bonvoisin C, Hamoir E, et al. The closure of arteriovenous fistula in kidney transplant recipients is associated with an acceleration of kidney function decline. Nephrol Dial Transplant. 2017;32(1):196-200. https://doi.org/10.1093/ndt/gfw351
Rao NN, Stokes MB, Rajwani A, Ullah S, Williams K, King D, et al. Effects of arteriovenous fistula ligation on cardiac structure and function in kidney transplant recipients. Circulation. 2019 Jun;139(25):2809-18. https://doi.org/10.1161/CIRCULATIONAHA.118.038505
Zheng H, Bu S, Song Y, Wang M, Wu J, Chen J. To ligate or not to ligate: a meta-analysis of cardiac effects and allograft function following arteriovenous fistula closure in renal transplant recipients. Ann Vasc Surg. 2020;63:287-92. https://doi.org/10.1016/j.avsg.2019.06.040
Golper TA. The arteriovenous fistula and progression of kidney disease. Kidney360. 2021;2(1):4-6. https://doi.org/10.34067/kid.0006262020
Fraser CD, Grimm JC, Liu RH, Wesson RN, Azar F, Beaulieu RJ, et al. Removal of non-infected arteriovenous fistulae after kidney transplantation is a safe and beneficial management strategy for unused dialysis access. Ann Vasc Surg. 2018;53:128-32. https://doi.org/10.1016/j.avsg.2018.04.020
Cruz Abascal RE, Ramírez Gómez JI, Gutiérrez Gutiérrez C, Barreto Fiu EE, Hernández Fernández ME, González Cárdenas Y. Angioaccesos en receptores de trasplante renal. Dilemas a la luz del síndrome cardiorrenal tipo 4. Rev Nefrol Dial Traspl. 2023;43(4):208-18. https://www.revistarenal.org.ar/index.php/rndt/article/view/945
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