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Calcium phosphate product level as a predictor for arteriovenous fistula re-operations in patients with chronic renal
Mehmet Erin Tüysüz1, Mehmet Dedemoğlu2
11 Department of Cardiovascular Surgery, Mersin City Education and Research Hospital, Turkey.
Insights
High calcium phosphate product levels increase the risk of arteriovenous fistula re-operations in chronic renal failure patients. Maintaining optimal levels can reduce re-operation rates and associated cardiovascular issues.
Area of Science:
- Nephrology
- Vascular Surgery
- Cardiovascular Medicine
Background:
- Elevated calcium phosphate product levels contribute to arterial calcification.
- Arterial calcification impairs arteriovenous fistula quality in chronic renal failure patients.
- Arteriovenous fistula re-operation is a significant concern in this population.
Purpose of the Study:
- To investigate the relationship between high calcium phosphate product levels and arteriovenous fistula re-operation.
- To identify risk factors associated with arteriovenous fistula re-operation.
Main Methods:
- A cohort of 79 chronic renal failure patients was studied.
- Patients were divided into two groups based on calcium phosphate product levels (≥50 mg²/dl² vs. <50 mg²/dl²).
- Multivariate logistic regression was used to determine independent predictors for re-operation.
Main Results:
- Re-operation rates were significantly higher in the group with elevated calcium phosphate product levels.
- Phosphate and triglyceride levels were independent predictors for redo operations.
- Calcium phosphate product level was an independent predictor for tredo operations.
Conclusions:
- High calcium phosphate product levels increase the risk of arteriovenous fistula re-operation due to arterial stiffness.
- Arteriovenous fistula re-operations increase morbidity and healthcare costs.
- Maintaining optimal calcium phosphate product levels is recommended to prevent re-operations and cardiovascular complications.
Objectives:
There is an increased calcium phosphate product level causing the formation of calcification in the arterial wall and thus decreased quality of fistula in patients with chronic renal failure. The purpose of our study is to verify the relationship between arteriovenous fistula re-operation and high calcium phosphate product level.
Methods:
Seventy-nine consecutive patients with chronic renal failure between April 2016 and February 2018 were included in the study. Patients having calcium phosphate product level ≥50 mg2/dl2 were defined as group 1, whereas those having <50 mg2/dl2 were defined as group 2. Primary outcome of interest was the need for re-operation during the follow-up and to determine the risk factors for re-operation. To determine independent predictors for re-operation, multivariate logistic regression model was used.
Results:
The rates of redo and tredo operation were significantly higher in group 1 compared to group 2 ( p = 0.01 and 0.04). In multivariate analysis, phosphate (OR: 1.84, 95% CI: 1.00-3.40, p = 0.05) and triglyceride (OR: 1.01, 95% CI: 1.00-1.02, p = 0.04) levels for redo operation and calcium phosphate product level (OR: 1.11, 95% CI: 1.01-1.22, p = 0.03) for tredo operation were found to be independent predictors.
Conclusions:
High calcium phosphate product level leads to increased risk of arteriovenous fistula re-operation by causing arterial stiffness in this patient group. Additionally, these re-operations place additional burden on morbidity and cost efficacy. Thus, we recommend keeping the calcium phosphate product level at the optimal level in these patients to avoid both the risk of arteriovenous fistula re-operation and the other cardiovascular problems.
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