Huanhuan Zheng1, Shuangshan Bu2, Yan Song3, Meifang Wang3, Jianyong Wu4, Jianghua Chen3. 1. Kidney Disease Center, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, People's Republic of China; Key Laboratory of Kidney Disease Prevention and Control Technology, Hangzhou, Zhejiang, People's Republic of China; National Key Clinical Department of Kidney Diseases, Hangzhou, Zhejiang, People's Republic of China; Institute of Nephrology, Zhejiang University, Hangzhou, Zhejiang, People's Republic of China; The Third Grade Laboratory under The National State Administration of Traditional Chinese Medicine, Hangzhou, Zhejiang, People's Republic of China; Department of Nephrology, Dongyang People's Hospital, Dongyang, Zhejiang, People's Republic of China. 2. Department of Nephrology, Dongyang People's Hospital, Dongyang, Zhejiang, People's Republic of China. 3. Kidney Disease Center, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, People's Republic of China; Key Laboratory of Kidney Disease Prevention and Control Technology, Hangzhou, Zhejiang, People's Republic of China; National Key Clinical Department of Kidney Diseases, Hangzhou, Zhejiang, People's Republic of China; Institute of Nephrology, Zhejiang University, Hangzhou, Zhejiang, People's Republic of China; The Third Grade Laboratory under The National State Administration of Traditional Chinese Medicine, Hangzhou, Zhejiang, People's Republic of China. 4. Kidney Disease Center, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, People's Republic of China; Key Laboratory of Kidney Disease Prevention and Control Technology, Hangzhou, Zhejiang, People's Republic of China; National Key Clinical Department of Kidney Diseases, Hangzhou, Zhejiang, People's Republic of China; Institute of Nephrology, Zhejiang University, Hangzhou, Zhejiang, People's Republic of China; The Third Grade Laboratory under The National State Administration of Traditional Chinese Medicine, Hangzhou, Zhejiang, People's Republic of China. Electronic address: wujianyong1964@zju.edu.cn.
Abstract
BACKGROUND: There are no available guidelines regarding preserving or ligating an arteriovenous fistula following successful kidney transplantation. Therefore, we performed a meta-analysis to formulate a clear opinion regarding the status of arteriovenous fistula in renal allograft recipients. METHODS: We performed an electronic literature search of PubMed, EMBASE, and the Cochrane Library for eligible studies up to January 2019. We aimed to systematically evaluate cardiac systolic and diastolic function and allograft function after arteriovenous fistula closure. The primary outcome was the differences in left ventricular mass index, left ventricular end-diastolic diameter, ejection fraction, and serum creatinine levels between patients with occluded arteriovenous fistula versus patent arteriovenous fistula. RESULTS: Renal transplant recipients with occluded arteriovenous fistula had lower left ventricular mass index values and left ventricular end-diastolic diameter compared with those with patent arteriovenous fistula. The pooled mean differences were 21.67 (95% confidence interval [CI] 19.94 to 23.39, P < 0.001) and 2.75 (95% CI 1.47 to 4.04, P < 0.001), respectively. Patients with occluded arteriovenous fistula also had lower serum creatinine levels versus those with patent arteriovenous fistula. The pooled mean difference was 0.10 (95% CI 0.04 to 0.17, P = 0.003). We saw no difference regarding ejection fraction between the groups. The pooled mean difference was 0.84 (95% CI -0.85 to 2.53, P = 0.33). CONCLUSIONS: Our meta-analysis demonstrated that arteriovenous fistula closure improves cardiac morphology and has better kidney graft function. Arteriovenous fistula closure may be considered in patients with a well-functioning allograft.
BACKGROUND: There are no available guidelines regarding preserving or ligating an arteriovenous fistula following successful kidney transplantation. Therefore, we performed a meta-analysis to formulate a clear opinion regarding the status of arteriovenous fistula in renal allograft recipients. METHODS: We performed an electronic literature search of PubMed, EMBASE, and the Cochrane Library for eligible studies up to January 2019. We aimed to systematically evaluate cardiac systolic and diastolic function and allograft function after arteriovenous fistula closure. The primary outcome was the differences in left ventricular mass index, left ventricular end-diastolic diameter, ejection fraction, and serum creatinine levels between patients with occluded arteriovenous fistula versus patent arteriovenous fistula. RESULTS: Renal transplant recipients with occluded arteriovenous fistula had lower left ventricular mass index values and left ventricular end-diastolic diameter compared with those with patent arteriovenous fistula. The pooled mean differences were 21.67 (95% confidence interval [CI] 19.94 to 23.39, P < 0.001) and 2.75 (95% CI 1.47 to 4.04, P < 0.001), respectively. Patients with occluded arteriovenous fistula also had lower serum creatinine levels versus those with patent arteriovenous fistula. The pooled mean difference was 0.10 (95% CI 0.04 to 0.17, P = 0.003). We saw no difference regarding ejection fraction between the groups. The pooled mean difference was 0.84 (95% CI -0.85 to 2.53, P = 0.33). CONCLUSIONS: Our meta-analysis demonstrated that arteriovenous fistula closure improves cardiac morphology and has better kidney graft function. Arteriovenous fistula closure may be considered in patients with a well-functioning allograft.
Authors: Tania Salehi; Nicholas J Montarello; Nishant Juneja; Michael B Stokes; Daniel J Scherer; Kerry F Williams; David King; Ewan Macaulay; Christine H Russell; Santosh A Olakkengil; Robert P Carroll; Randall J Faull; Karen S L Teo; Stephen P McDonald; Matthew I Worthley; Patrick T Coates; Nitesh N Rao Journal: Kidney360 Date: 2021-05-18
Authors: Marco Panagrosso; Umberto Marcello Bracale; Luca Del Guercio; Alessia Viscardi; Antonio Peluso; Ettore Dinoto Journal: Int J Surg Case Rep Date: 2020-08-27