Arteriovenous fistula for hemodialysis in renal transplant recipients. Clinical, humoral and cardiovascular repercussions
Keywords:
arteriovenous fistula, functioning renal transplant, clinical, laboratory and echocardiographic variables.Abstract
Introduction: Arteriovenous fistula for hemodialysis has a negative impact on hemodynamics, morphology, and cardiac functions.
Objective: To determine the repercussion of vascular access closure on clinical, humoral, morphological and functional variables of the right heart in renal transplant recipients.
Material and Methods: Quasi-experimental longitudinal study that included 92 patients divided into two groups: experimental (n=46): with vascular access closure, and comparison (n=46): those who did not have the angioaccess closed. Clinical, laboratory and echocardiographic variables were determined at two points in time: initial and six months later.
Results: The mean age in both groups was 46.87 ±12.04 and 45.50 ±12.47 years, respectively. Male sex: 26 (56.52 %), as well as white skin color: 34 (73.91 %), prevailed in the study. Palpitations were the most frequent clinical manifestation with improvement at the second observation in the experimental group, as were systolic and diastolic pressures, as well as serum creatinine: from 108.24 ±24.53 to 100.00 ±22.35 μMol/L (p=0,004). The variables measured by echocardiography improved in the intervention group with respect to the comparison group. The final - initial differences for systolic and mean pulmonary artery pressures showed highly significant relationships (p<0.001) for fistulas located at the left wrist and elbow crease.
Conclusions: The variables studied showed ostensible changes in the experimental group with respect to the comparison after closure of the arteriovenous fistula without finding an association between their location and the severity of cardiac involvement.
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