SP590
NUTRITIONAL STATUS IN ADVANCED CHRONIC KIDNEY DISEASE AND ITS INFLUENCE ON THE INITIAL FUNCTIONING OF INTERNAL ARTERIOVENOUS FISTULAS

INTRODUCTION: Hemodialysis (HD) treatment requires a vascular access (VA) developed. The role of hemodynamic and biochemical markers as independent prognostic factors has gained importance; In recent years, preoperative circulating serum albumin as a prognostic marker for success / failure in general surgery has been investigated, although its relation to the creation of AVFi is unknown. We identify risk factors and biochemical markers that may influence the initial functioning after the creation of a VA for HD.

METHODS: Prospective observational study; we included all the VAs performed in patients on HD or ERCA in the HGUCR from 2009-2018. We evaluate the initial functioning after the creation of the AV. Demographic variables (age, sex), etiology of CKD and associated comorbidity were collected. The categorical variables are expressed as percentages and compared by the Chi2 test. The quantitative variables are expressed as mean ± standard deviation and the t-student was used to compare them.

RESULTS: A total of 477 VAs performed in 383 patients between October 2009 and April 2018 were reviewed. A total of 415 autologous AV (86.6%) and 64 AV prosthetic AV (13.4%) were performed. The average age of the patients was 65.5 ± 13.8 years and 65.3% were male. The most frequent etiology of CKD was diabetic nephropathy (28.6%), followed by non-affiliated nephropathy (21.4%) and glomerulonephritis (16.1%). 90.1% of the patients presented hypertension (HT), diabetes mellitus (DM) 48.2%. 49.5% were receiving antiaggregant treatment and 15.5% anticoagulant treatment prior to the creation of the VA. Primary permeability showed 79.1% of AV. We observed significant differences between the immediate functioning of the VA and the age of the patient (p = 0.02), platelet levels (p = 0.02), presence of hypertension (p = 0.04), and the taking of antiplatelet therapy (p <0.01) prior to the creation of the AV. The levels of albumin prior to the creation of the VA did not reach statistical significance (p = 0.06).

CONCLUSIONS: In our experience, 79.1% of the AV created presented primary functioning, being the condition of HT, DL, antiaggregation and age, factors associated with the initial functioning of VA in our study. Low levels of serum albumin in relation to malnutrition could be related to the primary failure of the AVF, although in our study it did not achieve statistical significance, so further studies are needed to confirm this.