Abstract: SA-PO952
Risk Factors Associated with Distal Hypoperfusion Ischemic Syndrome in Patients with an Arteriovenous Access
Session Information
- Dialysis: Vascular Access - II
October 27, 2018 | Location: Exhibit Hall, San Diego Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 704 Dialysis: Vascular Access
Authors
- Karim, Muhammad Sohaib, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, United States
- Gardezi, Ali I., University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, United States
- Bennett, Kyla M., University of Wisconsin, Madison, Wisconsin, United States
- Astor, Brad C., University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, United States
- Chan, Micah R., University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, United States
Background
Steal syndrome, or distal hypoperfusion ischemic syndrome (DHIS), is a complication in up to 20% of patients using an arteriovenous access such as a fistula or synthetic graft for chronic hemodialysis. The purpose of this study was to determine the risk factors associated with the development of DHIS.
Methods
Thirty-nine (39) patients with a diagnosis of DHIS were identified and compared to thirty-nine (39) randomly selected patients with arteriovenous access without DHIS (control group) from December 2008 to September 2017. Univariate and multivariate analysis were done to assess the relationship between development of DHIS and risk factors such as age, gender, race, distal versus proximal location of vascular access, peripheral vascular disease, diabetes and congestive heart failure.
Results
Risk of DHIS did not differ significantly by age, race, diabetes mellitus, coronary artery disease or peripheral vascular disease (Table 1). Proximal versus distal placement of access (odds ratio= 5.98, 95 % CI: 1.35, 26.42) as well as female gender (odds ratio= 4.15, 95 % CI: 1.35, 12.76) were associated with a higher incidence of DHIS.
Conclusion
Age, race, congestive heart failure, diabetes and peripheral vascular disease did not appear to be risk factors associated with the development of distal hypoperfusion ischemic syndrome. Female gender and proximal location of vascular access were associated with significantly higher risk of DHIS. Further studies are required to investigate these findings.
Results
| Distal hypoperfusion ischemic syndrome | Odds ratio | 95 % CI | Standard Error | P Value |
| Age per Decade | 1.07 | 0.69 to 1.66 | 0.240 | 0.752 |
| Female | 4.15 | 1.35 to 12.76 | 2.37 | 0.013 |
| African American | 2.71 | 0.67 to 10.95 | 1.93 | 0.161 |
| Diabetes Mellitus | 0.91 | 0.29 to 2.85 | 0.53 | 0.877 |
| CHF | 1.43 | 0.45 to 4.45 | 0.82 | 0.536 |
| PVD | 2.68 | 0.66 to 10.83 | 1.91 | 0.166 |
| Proximal versus distal location of access | 5.98 | 1.35 to 26.42 | 4.53 | 0.018 |