Correlation between preoperative cephalic vein pathological types and autogenous arteriovenous fistula (AVF) maturation in patients with stage 5 chronic kidney disease

To explore the correlation between preoperative cephalic vein pathological types and the maturation of autogenous arteriovenous fistula (AVF) in patients with chronic kidney disease (CKD), providing new ideas and methods for clinical prediction of fistula maturation.

A retrospective analysis was performed in 80 patients who underwent AVF creation surgery from June 2021 to June 2023 at our hospital. Patients were followed up for 6 months. Patients were classified into the mature group (n = 57) and the power loss group (n = 23) based on the AVF maturation status. Preoperative excised venous tissues were examined using Masson’s trichrome staining to compare the intimal area (Ia), medial area (Ma), lumen diameter (Ld), average intimal thickness (Avg It), and average medial thickness (Avg Mt), along with the calculations and comparisons of Ia/Ma, Avg It/Avg Mt ratios. Factors influencing AVF power loss were identified using the multifactorial logistic regression analysis.

Ia, Ia/Ma, and Ld were lower in the power loss group compared to the mature group (P < 0.01). No significant difference was found in Avg Mt and Avg It/Avg Mt levels between the two groups (P > 0.05). The level of Avg It was higher in the power loss group (P < 0.05). Avg It was a risk factor (P < 0.001), while Ld was a protective factor for AVF power loss (P < 0.05).

The levels of Avg It and Ld in preoperative cephalic vein tissue before AVF formation were correlated with AVF power loss. Early monitoring may improve therapeutic outcomes and prognosis of patients with stage 5 CKD.