Is using antihypertensive drugs before arteriovenous fistula surgery effective on fistula thrombosis in patients with hypertension?

Abstract

Background: The number of patients with end-stage renal disease (ESRD) and the need for hemodialysis (HD) has increased and they needed repeated intervention to maintain access patency. Care of hemodialysis patients has considerable economic burden on health care system. The effects of antihypertensive medications on arteriovenous fistula (AVF) thrombosis are not clearly explained. This study aimed to evaluate the effects of continuing and discontinuing use of antihypertensive medications in peri-operative time on arteriovenous fistula thrombosis. Methods: This was a clinical trial study on 60 patients with ESRD and hypertension, candidates for hemodialysis that divided into two groups. The case group received their antihypertensive drug before surgery and the control group did not receive. Systolic, diastolic, and mean arterial blood pressure and heart rate were evaluated before and during surgery; the incidence of thrombosis immediately, 24 hours, and one week after surgery was evaluated as well. Findings: Patients with mean age of 58.85 ± 14.95 years were participated that 78.4 of them were men. The mean systolic blood pressure was higher in control group but this difference was just statistically significant before surgery and at the start of administering local anesthesia. Just before surgery, the mean diastolic blood pressure and mean arterial blood pressure were higher in control group significantly. The number of thrombosis in case group was higher significantly than control group immediately (P = 0.03), 24 hours (P = 0.04), and one week (P =0.02) after the surgery. Conclusion: Using antihypertensive medications in patients, candidates for arteriovenous fistula, increased the risk of arteriovenous fistula thrombosis. © 2017, Isfahan University of Medical Sciences(IUMS). All rights reserved.