Logo image
Back
Angiotensin converting enzyme inhibitors maintain polytetrafluroethylene graft patency
Journal article   Peer reviewed

Angiotensin converting enzyme inhibitors maintain polytetrafluroethylene graft patency

Atul Sajgure, Arindam Choudhury, Ziauddin Ahmed and Devasmita Choudhury
Nephrology, dialysis, transplantation, v 22(5), pp 1390-1398
May 2007
DOI: https://doi.org/10.1093/ndt/gfl821
PMID: 17267534
Featured in Collection :   UN Sustainable Development Goals @ Drexel

Abstract

angiotensin converting enzyme inhibitors dialysis fistulas grafts patency thrombosis
Background. A patent vascular access is crucial for hemodialysis patients. Stenosis and thrombosis lead to access failure. Endothelial injury via angiotensin II may mediate a hyperplastic and prothrombotic response. Thus angiotensin II inhibition with angiotensin-converting enzyme inhibitors (ACEI) may prolong vascular access patency. This study determines the impact of ACEI use on access patency in both polytetrafluroethylene (PTFE) grafts and fistulas. Methods. Demographics, access history and medication use were reviewed in 266 accesses from four dialysis centres. Primary patency, date of surgery to date of first access failure, was determined. Excluded accesses had incomplete history or <30 day patency. Groups divided into ACEI and non-ACEI based on patient use of ACEI during access patency. Statistical methods included: unpaired Student t to compare continuous variables, Chi-square and Fisher's Exact test to compare proportions and evaluate for risk estimation, univariate and multivariate Cox regression to investigate variables associated with duration of access patency. Cox-adjusted survival and Hazard curves were obtained for significant variables. Results. Non-ACEI (PTFE) graft group included more males and older patients; however, when these covariates were adjusted during both univariate and multivariate regression, suggested, only ACEI use was associated with greater access patency duration, 671.7 days (ACEI) vs 460.0 days (non-ACEI), p = 0.012. ACEI group had fewer clotting events, 55% versus 71% (non-ACEI) group, p = 0.042. ACEI use had little effect on primary patency of the fistula however male gender increased time to fistula failure, p = 0.002. Conclusions. Retrospective evaluation suggests ACEI use in patients with PTFE grafts may prolong and maintain patency. Fistula patency is affected by gender with longer patency noted in males. Further prospective studies are necessary to confirm the role of ACEI in maintaining vascular access patency.

Metrics

11 Record Views
25 citations in Web of Science
29 citations in Scopus

Details

UN Sustainable Development Goals (SDGs)

This publication has contributed to the advancement of the following goals:

#3 Good Health and Well-Being

InCites Highlights

Data related to this publication, from InCites Benchmarking & Analytics tool:

Collaboration types
Domestic collaboration
International collaboration
Web of Science research areas
Transplantation
Urology & Nephrology
Logo image