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Risk factors for thrombosis in dialysis patients: A comprehensive systematic review and meta-analysis.

Authors :
Shiri, Parisa
Rezaeian, Shabab
Abdi, Alireza
Jalilian, Milad
Khatony, Alireza
Source :
Journal of Vascular Nursing; Sep2024, Vol. 42 Issue 3, p165-176, 12p
Publication Year :
2024

Abstract

• AV grafts had significantly higher thrombosis risk than AV fistulas (OR = 10.93, 95 % CI: 9.35-12.78, P = 0.001). • Hemodialysis patients had 3.60 times higher thrombosis risk than non-hemodialysis patients (OR = 3.60, 95 % CI: 3.54-4.19, P = 0.001). • Single-stage basilic vein transposition increased thrombosis risk by 1.89 times compared to two-stage transposition (OR = 1.89, 95 % CI: 1.04-3.46, P = 0.038). To identify the factors associated with thrombosis in dialysis patients. Thrombosis is a leading cause of vascular access failure in dialysis patients. Numerous risk factors contribute to thrombosis in this population. A systematic search was conducted across international databases using standardized keywords. The quality of the selected studies was assessed using the STROBE and CONSORT checklists. The findings were summarized in a Garrard table. Meta-analysis was performed using CMA software. The study adhered to the guidelines outlined in the PRISMA statement. A total of 180 articles were reviewed. The odds ratio for thrombosis in patients with arteriovenous grafts compared to arteriovenous fistulas was 10.93 (95 % CI: 9.35-12.78), demonstrating statistical significance (P = 0.001). Similarly, hemodialysis patients had an odds ratio of thrombosis 3.60 times higher than non-hemodialysis patients (95 % CI: 3.54-4.19), with statistical significance (P = 0.001). Patients undergoing single-stage basilic vein transposition had a 1.89 times higher risk of thrombosis compared to those undergoing two-stage transposition (95 % CI: 1.04-3.46), also demonstrating statistical significance (P = 0.038). Thrombosis in patients with end-stage renal disease undergoing dialysis was significantly associated with various factors, including graft access, single-stage basilic vein transposition, and hemodialysis. Additional contributing factors to thrombosis included diabetes, elevated homocysteine levels, female gender, age over 50, access location, and low access blood flow velocity. The analysis revealed a higher incidence of thrombosis in end-stage renal disease patients undergoing hemodialysis compared to those not undergoing dialysis, as well as in patients with arteriovenous grafts compared to those with arteriovenous fistulas. These findings underscore the importance of recognizing and managing these risk factors to prevent thrombotic events and enhance patient care within the dialysis setting. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
10620303
Volume :
42
Issue :
3
Database :
Supplemental Index
Journal :
Journal of Vascular Nursing
Publication Type :
Academic Journal
Accession number :
179465451
Full Text :
https://doi.org/10.1016/j.jvn.2024.05.002