Factors influencing arteriovenous fistula dysfunction in Japanese patientson chronic hemodialysis

Arteriovenous fistula dysfunction is a constant problem in chronic hemodial ysis patients. We investigated the factors influencing fistula dysfunction in 184 patients on chronic hemodialysis. Stepwise regression analysis and C ox proportional hazards model were used to assess the relationship between fistula dysfunction and age, sex, duration of hemodialysis, diabetes mellit us, hematocrit, serum creatinine, blood urea nitrogen, Kt/V; prothrombin ti me, blood pressure, anticoagulant therapy, dose of erythropoietin, calcium channel blocker therapy, and angiotensin-converting enzyme inhibitor therap y. Fistula dysfunction showed a significant relationship with a low systoli c blood pressure, a low hematocrit, the presence of diabetes mellitus, and angiotensin-converting enzyme inhibitor therapy. These results suggested th at treatment with angiotensin-converting enzyme inhibitors may help to prev ent fistula dysfunction.