The Turkish Journal of Vascular Surgery
Yazarlar: Mahmut BİÇER, Orhan BOZOĞLAN, Faruk SERHATLIOĞLU, Kutay TAŞDEMİR
Konular:-
Anahtar Kelimeler:Arteriovenous fistula; fistula maturation; heavy metal effect
Özet: Objective: It was aimed to investigate the effects of heavy metals such as aluminum (Al), arsenic (As), calcium (Ca), cobalt (Co), chromium (Cr), iron (Fe), nickel (Ni), lithium (Li) and zinc (Zn) on the maturation of arteriovenous fistulas formed at the level of wrist for hemodialysis, and to draw attention to levels of heavy metals in patients with chronic renal failure (CRF). Material and Methods: Forty cases, in whom first arteriovenous fistulas were created at the level of wrist in vascular surgery department between November 2011 and April 2012 were included in the study. In all pa- tients, normal circulation system was confirmed by performing examination for the arterial and venous system in the upper extremity. A radiocephalic arteriovenpus fistula was formed at the level of wrist in patients with appropriate arterial and venous structures. A cephalic vein specimen, approximately 2 cm in size, was obtained during surgery. Venous blood samples were drawn after surgery. Patients were reevaluated by using Doppler ultrasonography 4 weeks after the operation or later, and divided into two group according to cephalic vein flow as follows: patients with cephalic vein flow <200 ml/min and those with cephalic vein flow >200 ml/min. Results: There were 20 men and 20 women with a mean age of 61.08±13.41 years. There was hypertension in 11 and diabetes mellitus in 12 patients. Of the 40 cases, 29 (72.5%) had functioning fistulas while 11 (11.75%) had non-functioning fistulas in the control visit. A correlation was found between the age and the flow. In addition, there was a correlation between flow and tissue Ca levels or serum Ni, FE and Cr values. Conclusion: A negative correlation was found between the age and the flow of cephalic vein. As age advances, the flow of cephalic vein decreases. A positive correlation was found between fistula maturation and serum Ni, Fe and Cr levels. No correlation was detected between fistula maturation and tissue heavy metals.