Korean Journal of Nephrology 2010;29(4):474-481.
Can Cilostazol Improve the Patency Rate of Native Arteriovenous Fistula in Hemodialysis Patients?
Jung Sub Kim, M.D., Mun Ki Choi, M.D., Bo Kyung Choi, M.D., Hee Sun Lee, M.D., Naria Lee, M.D., JungMin Son, M.D., Eun Young Seong, M.D., Sang Heon Song, M.D., Soo Bong Lee, M.D. and Ihm Soo Kwak, M.D.
Department of internal Medicine, Pusan National University School of Medicine, Busan, Korea
원저 : 자가혈관 동정맥루 생존율에 대한 Cilostazol의 효과
김정섭, 최문기, 최보경, 이희선, 이나리아, 손정민, 성은영, 송상헌, 이수봉, 곽임수
부산대학교 의학전문대학원 내과학교실
Abstract
Purpose: Vascular access failure is the most common reason for hospitalization among hemodialysis (HD) patients. Cilostazol, which has antiplatelet action and vasodialtory effects, significantly reduces the risk of restenosis after percutaneous coronary intervention in many patients. We conducted this study to evaluate the relationship between the use of antiplatelet agents, especially cilostazol, and arteriovenous fistula (AVF) patency in HD patients. Methods: A total of 241 patients underwent native AVF creation from January 2001 to December 2008. Among these patients, we selected 86 patients excluding 38 patients (15.8%) with primary technical failure, 49 patients without complete data and 68 patients used cilostazol less than 1 month. Demographic characteristics, medication history and fistula failure rate were collected and analyzed to elucidate the effect of cilostazol to native AVF. Results: From all groups, AVF failure occurred in 24 patients (27.9%). 28 patients received cilostazol (62.3 %) and mean duration of cilostazol therapy was 229.5±115.7 days. All patients were classified into two groups according to cilostazol (Cilostazol [n=28, 32.6%] vs. non-Cilostazol [n=58, 67.4%]. There was no statisticallly significant difference in failure rate between the two groups (32.1% vs. 25.9%, p=0.543). In diabetes group, patients who received statin have much lower AVF failure rate (0% vs. 32.4%, p=0.024). Logistic regression analysis showed that female was independent risk factor for access failure (HR 5.549, CI 1.104-27.877, p=0.037). Conclusion: Cilostazol and other antiplatelet agent had a no significant association with AVF patency. Female was an independent risk factor for access failure.
Key Words: Arteriovenous fistula, Cilostazol, Vascular patency


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