Risk Factor Analysis in Vascular Access Complications for Hemodialysis Patients

<b>Background:</b> Chronic kidney disease (CKD) and renal failure remain critical global health challenges, with vascular access complications posing significant obstacles in hemodialysis management. <b>Methods:</b> This study investigates the early and late complications ass...

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Main Authors: Cristian Dan Roşu, Sorin Lucian Bolintineanu, Bogdan Florin Căpăstraru, Roxana Iacob, Emil Robert Stoicescu, Claudia Elena Petrea
Format: Article
Language:English
Published: MDPI AG 2025-01-01
Series:Diagnostics
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Online Access:https://www.mdpi.com/2075-4418/15/1/88
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author Cristian Dan Roşu
Sorin Lucian Bolintineanu
Bogdan Florin Căpăstraru
Roxana Iacob
Emil Robert Stoicescu
Claudia Elena Petrea
author_facet Cristian Dan Roşu
Sorin Lucian Bolintineanu
Bogdan Florin Căpăstraru
Roxana Iacob
Emil Robert Stoicescu
Claudia Elena Petrea
author_sort Cristian Dan Roşu
collection DOAJ
description <b>Background:</b> Chronic kidney disease (CKD) and renal failure remain critical global health challenges, with vascular access complications posing significant obstacles in hemodialysis management. <b>Methods:</b> This study investigates the early and late complications associated with vascular access procedures in a cohort of 1334 patients from Timiș County Emergency Clinical Hospital. Patients were categorized into early complications, occurring within 30 days postoperatively, and late complications, developing beyond this period. Demographic data, comorbidities, and lifestyle factors, including age, gender, body mass index (BMI), smoking status, hypertension, diabetes, and cardiovascular disease (CVD), were recorded and analyzed. Early complications included thrombosis, hemorrhage, edema, and non-maturation, while late complications involved thrombosis, aneurysmal dilation, venous hypertension, and infections. <b>Results</b>: Hemorrhage (32.3%) and thrombosis (30.8%) were the most prevalent early complications, influenced significantly by diabetes and hypertension. Non-maturation showed a strong association with diabetes and cardiovascular disease (odds ratio: 1.70). For late complications, thrombosis was most frequent, with hypertensive patients exhibiting increased risk (relative risk: 1.18). BMI was a significant factor in both early and late complications. Risk analysis using odds ratios and relative risks revealed distinct patterns of complication risks based on comorbidities and smoking status. Logistic regression modeling for thrombosis demonstrated moderate predictive accuracy (AUC: 0.64). <b>Conclusions</b>: These findings suggest that clinical interventions, such as stricter perioperative glycemic and blood pressure control, and personalized surgical strategies for patients with high BMI or comorbidities, could significantly reduce the incidence of vascular access complications and improve outcomes in this high-risk population.
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spelling doaj-art-7c6d375ed0c24b9ea99dd46ebae867e42025-01-10T13:16:41ZengMDPI AGDiagnostics2075-44182025-01-011518810.3390/diagnostics15010088Risk Factor Analysis in Vascular Access Complications for Hemodialysis PatientsCristian Dan Roşu0Sorin Lucian Bolintineanu1Bogdan Florin Căpăstraru2Roxana Iacob3Emil Robert Stoicescu4Claudia Elena Petrea51st Surgery Clinic, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square No. 2, 300041 Timisoara, RomaniaDepartment of Anatomy and Embriology, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, RomaniaDoctoral School, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square No. 2, 300041 Timisoara, RomaniaDepartment of Anatomy and Embriology, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, RomaniaField of Applied Engineering Sciences, Specialization Statistical Methods and Techniques in Health and Clinical Research, Faculty of Mechanics, “Politehnica” University Timisoara, Mihai Viteazul Boulevard No. 1, 300222 Timisoara, RomaniaDepartment of Anatomy and Embriology, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania<b>Background:</b> Chronic kidney disease (CKD) and renal failure remain critical global health challenges, with vascular access complications posing significant obstacles in hemodialysis management. <b>Methods:</b> This study investigates the early and late complications associated with vascular access procedures in a cohort of 1334 patients from Timiș County Emergency Clinical Hospital. Patients were categorized into early complications, occurring within 30 days postoperatively, and late complications, developing beyond this period. Demographic data, comorbidities, and lifestyle factors, including age, gender, body mass index (BMI), smoking status, hypertension, diabetes, and cardiovascular disease (CVD), were recorded and analyzed. Early complications included thrombosis, hemorrhage, edema, and non-maturation, while late complications involved thrombosis, aneurysmal dilation, venous hypertension, and infections. <b>Results</b>: Hemorrhage (32.3%) and thrombosis (30.8%) were the most prevalent early complications, influenced significantly by diabetes and hypertension. Non-maturation showed a strong association with diabetes and cardiovascular disease (odds ratio: 1.70). For late complications, thrombosis was most frequent, with hypertensive patients exhibiting increased risk (relative risk: 1.18). BMI was a significant factor in both early and late complications. Risk analysis using odds ratios and relative risks revealed distinct patterns of complication risks based on comorbidities and smoking status. Logistic regression modeling for thrombosis demonstrated moderate predictive accuracy (AUC: 0.64). <b>Conclusions</b>: These findings suggest that clinical interventions, such as stricter perioperative glycemic and blood pressure control, and personalized surgical strategies for patients with high BMI or comorbidities, could significantly reduce the incidence of vascular access complications and improve outcomes in this high-risk population.https://www.mdpi.com/2075-4418/15/1/88chronic kidney diseasehemodialysisvascular access complicationsthrombosishemorrhagenon-maturation
spellingShingle Cristian Dan Roşu
Sorin Lucian Bolintineanu
Bogdan Florin Căpăstraru
Roxana Iacob
Emil Robert Stoicescu
Claudia Elena Petrea
Risk Factor Analysis in Vascular Access Complications for Hemodialysis Patients
Diagnostics
chronic kidney disease
hemodialysis
vascular access complications
thrombosis
hemorrhage
non-maturation
title Risk Factor Analysis in Vascular Access Complications for Hemodialysis Patients
title_full Risk Factor Analysis in Vascular Access Complications for Hemodialysis Patients
title_fullStr Risk Factor Analysis in Vascular Access Complications for Hemodialysis Patients
title_full_unstemmed Risk Factor Analysis in Vascular Access Complications for Hemodialysis Patients
title_short Risk Factor Analysis in Vascular Access Complications for Hemodialysis Patients
title_sort risk factor analysis in vascular access complications for hemodialysis patients
topic chronic kidney disease
hemodialysis
vascular access complications
thrombosis
hemorrhage
non-maturation
url https://www.mdpi.com/2075-4418/15/1/88
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