SP576
ANTICOAGULATION AND ANTIAGREGGATION: IS THERE A RELATION WITH VASCULAR ACCESS PATENCY?

INTRODUCTION: Maintaining long-term vascular access patency is very important for hemodialysis (HD) performance.

We intend to evaluate the efficacy of anticoagulation and/or antiaggregation or no treatment to maintain vascular access patency in patients that constructed a vascular access.

METHODS: Retrospective study of vascular accesses constructed between July 2012 and April 2014 in a hospital facility. Data collected comprised demographic information, lab results (calcium, phosphorus, intact parathormone, total cholesterol, triglycerides), access patency and concomitant medication (anticoagulant, antiaggregant, statin and phosphate binders) every 12 months, during the 36-month period after the construction.

RESULTS: 236 patients, 64% were (n=151) males, medium age was 70.58±14.33 years, 41.5% (n=98) were diabetic, 92% (n=218) constructed an arterious-venous fistula (AVF) and 8% (n=18) PTFE vascular graft.

At the time of the surgery 6.4% (n=15) were anticoagulated, 44.1% (n=104) anti-aggregated, 44.1% (n=104) were medicated with statins and 29.8% (n=70) with phosphate binders.

A chi-square test was performed to examine the relation between patency at different time points (construction time, 1-month, 12-month, 24-month and 36-month) and concomitant medication. The relations between 12-month access patency and anticoagulation at time of construction (X2=0.098, p=0.005), phosphate binders with calcium at time of construction (X2=1.249, p=0.039) and at 12-month (X2=4.138, p=0.016) were significant.

An independent-samples t-test was conducted to compare age in patients with and without access patency maintained at 12-month and there was a significant difference (t=3.516, p=0.002).

CONCLUSIONS: There is moderate certainty that anticoagulation or antiaggregation makes little or no difference in the prevention of patency loss within 36-months. The relation with phosphate binders should be take in consideration in future studies.

No relation was found between gender, diabetes mellitus or lab results with patency.