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La Asociación Entre la Multimorbilidad y los Resultados de la Creación de Fístulas Arteriovenosas

Jose L Lopez¹, Theodore H Yuo², Mehrnaz Siavoshi³

¹University of California Los Angeles, Los Angeles, CA, Department of Surgery, Division of Vascular Surgery.

Journal of vascular surgery

|January 30, 2026

Resumen

La alta multimorbilidad, medida por el Índice Ponderado de Multimorbilidad (MWI), se asocia con peores resultados después de la creación de fístulas arteriovenosas (FAV) para el acceso de hemodiálisis. Un MWI más alto se correlaciona con una menor utilización de FAV y un aumento de las revisiones.

Área de la Ciencia:

Nefrología
Cirugía Vascular
Investigación de Servicios de Salud

Sus antecedentes:

El Índice Ponderado de Multimorbilidad (MWI) evalúa la carga acumulativa de la enfermedad y el impacto funcional.
La creación de fístulas arteriovenosas (FAV) es crucial para el acceso de hemodiálisis (HD).
Comprender los factores que influyen en los resultados de la FAV es vital para la atención al paciente.

Objetivo del estudio:

Examinar la asociación entre el MWI y los resultados a corto plazo de la creación de FAV.
Determinar si la multimorbilidad más alta afecta la funcionalidad de la FAV y la necesidad de revisión.

Principales métodos:

Revisión retrospectiva de datos de creación de FAV (2011-2019) de bases de datos nacionales.
Multimorbilidad evaluada utilizando el MWI, dicotomizada en la mediana.
Resultado primario: uso funcional de la FAV en 6 meses; resultado secundario: revisión de la FAV.
Se realizó un análisis de regresión logística multivariable.

Principales resultados:

Un MWI más alto se asoció con un menor uso de FAV en 6 meses (58,9 % frente a 64,6 %).
Los pacientes con un MWI más alto tuvieron más probabilidades de requerir una revisión de la FAV antes del primer uso (43,2 % frente a 36,2 %).
Un MWI más alto se correlacionó con un aumento de la mortalidad y una disminución de las probabilidades de uso de la FAV a los 6 meses.

Conclusiones:

Un MWI elevado en pacientes sometidos a creación de FAV indica peores resultados.
Un MWI más alto se asocia con un aumento de la mortalidad, una menor utilización de FAV y más revisiones.
El MWI puede ayudar en la planificación del acceso vascular y la toma de decisiones compartida.

Palabras clave:

Fístula arteriovenosa diálisis multimorbilidad diálisis renal

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