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Influence of intradialytic systolic blood pressure changes on arteriovenous access thrombosis in long-term hemodialysis patients
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  • Cai-Mei Zheng,
  • Yi-Ping Chiu,
  • Yi-Chou Hou,
  • Yueh-Min Liu,
  • Mai-Szu Wu,
  • Yuh-Feng Lin,
  • Yen-Li Lo,
  • Kuo-Cheng Lu,
  • Yung-Ho Hsu,
  • Yuan-Hung Wang
Cai-Mei Zheng
Taipei Medical University Shuang Ho Hospital Ministry of Health and Welfare
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Yi-Ping Chiu
Taipei Medical University Shuang Ho Hospital Ministry of Health and Welfare
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Yi-Chou Hou
Fu Jen Catholic University College of Medicine
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Yueh-Min Liu
Ching Kuo Institute of Management and Health
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Mai-Szu Wu
Taipei Medical University Shuang Ho Hospital Ministry of Health and Welfare
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Yuh-Feng Lin
Taipei Medical University Shuang Ho Hospital Ministry of Health and Welfare
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Yen-Li Lo
National Yang Ming University Department of Biomedical Engineering
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Kuo-Cheng Lu
Fu Jen Catholic University
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Yung-Ho Hsu
Taipei Medical University Shuang Ho Hospital Ministry of Health and Welfare
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Yuan-Hung Wang
Taipei Medical University Shuang Ho Hospital Ministry of Health and Welfare
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Abstract

Background: Arteriovenous access (AV) thrombosis is important and preventable problem among chronic hemodialysis (HD) patients. On the other hand, systolic blood pressure (SBP) alteration relates with higher cardiovascular mortality among these patients. In this study, we investigated the relation between SBP changes and arteriovenous access (AV) thrombosis. Methods: 50 HD patients with thrombosis and 50 HD patients without thrombosis were included in the study. Odds ratios and 95% confidence intervals were estimated with multivariate adjusted logistic regression models to determine the association between potential thrombosis-related risk factors and thrombosis risk. Results: Elder adults, women, and patients with arteriovenous grafts, lower intradialytic SBP and higher SBP variations during dialysis sessions had higher incidence of AV access thrombosis. Chronic inflammation and mineral metabolism related parameters were also found to be abnormal at the time of AV access thrombosis. Conclusions: Close monitoring and management of intra-dialytic hypotension, SBP variation in every dialysis session and correction of biochemical parameters are critical for earlier identification and prevention of AV access thrombosis in HD patients.

Peer review status:UNDER REVIEW

18 May 2020Submitted to International Journal of Clinical Practice
28 May 2020Submission Checks Completed
28 May 2020Assigned to Editor
02 Jun 2020Reviewer(s) Assigned
14 Jun 2020Review(s) Completed, Editorial Evaluation Pending
22 Jul 20201st Revision Received
25 Jul 2020Submission Checks Completed
25 Jul 2020Assigned to Editor
25 Jul 2020Reviewer(s) Assigned