Can Cilostazol Improve the Patency Rate of Native Arteriovenous Fistula in Hemodialysis Patients?.
- Author:
Jung Sub KIM
1
;
Mun Ki CHOI
;
Bo Kyung CHOI
;
Hee Sun LEE
;
Naria LEE
;
JungMin SON
;
Eun Young SEONG
;
Sang Heon SONG
;
Soo Bong LEE
;
Ihm Soo KWAK
Author Information
1. Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea. iskwak@pusan.ac.kr
- Publication Type:Original Article
- Keywords:
Arteriovenous fistula;
Cilostazol;
Vascular patency
- MeSH:
Arteriovenous Fistula;
Female;
Fistula;
Hospitalization;
Humans;
Hydroxymethylglutaryl-CoA Reductase Inhibitors;
Logistic Models;
Percutaneous Coronary Intervention;
Platelet Aggregation Inhibitors;
Renal Dialysis;
Risk Factors;
Tetrazoles;
Vascular Patency
- From:Korean Journal of Nephrology
2010;29(4):474-481
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: Vascular access failure is the most common reason for hospitalization among hemodialysis (HD) patients. Cilostazol, which has antiplatelet action and vasodialtory effects, significantly reduces the risk of restenosis after percutaneous coronary intervention in many patients. We conducted this study to evaluate the relationship between the use of antiplatelet agents, especially cilostazol, and arteriovenous fistula (AVF) patency in HD patients. METHODS: A total of 241 patients underwent native AVF creation from January 2001 to December 2008. Among these patients, we selected 86 patients excluding 38 patients (15.8%) with primary technical failure, 49 patients without complete data and 68 patients used cilostazol less than 1 month. Demographic characteristics, medication history and fistula failure rate were collected and analyzed to elucidate the effect of cilostazol to native AVF. RESULTS: From all groups, AVF failure occurred in 24 patients (27.9%). 28 patients received cilostazol (62.3 %) and mean duration of cilostazol therapy was 229.5+/-115.7 days. All patients were classified into two groups according to cilostazol (Cilostazol [n=28, 32.6%] vs. non-Cilostazol [n=58, 67.4%]. There was no statisticallly significant difference in failure rate between the two groups (32.1% vs. 25.9%, p=0.543). In diabetes group, patients who received statin have much lower AVF failure rate (0% vs. 32.4%, p=0.024). Logistic regression analysis showed that female was independent risk factor for access failure (HR 5.549, CI 1.104-27.877, p=0.037). CONCLUSION: Cilostazol and other antiplatelet agent had a no significant association with AVF patency. Female was an independent risk factor for access failure.
