[ABSTRAK
Pendahuluan Masalah utama pada ArterioVenous Fistula AVF adalah kegagalan maturasi Deteksi dini bahwa AVF akan mengalami gagal maturasi dibutuhkan sehingga memungkinkan untuk melakukan revisi atau membuat akses vaskular yang baru sesegera mungkin Diameter vena pra operasi adalah faktor prediktor independen dalam maturasi Tujuan penelitian ini adalah untuk mengetahui prediksi dini maturasi AVF berdasarkan peningkatan ukuran diameter draining vein pasca operasi minggu pertama Metode Penelitian dilakukan secara kohort retrospektif dengan mengambil data rekam medis pasien yang menjalani operasi pembuatan AVF di RSCM tahun 2013 2014 Diameter vena pra operasi dan diameter draining vein pasca operasi minggu pertama diukur dengan USG Doppler Peningkatan diameter draining vein pasca operasi minggu pertama dihubungkan dengan maturasi AVF Hasil Didapatkan 38 pasien dengan angka maturasi 81 6 Tidak didapatkan perbedaan maturasi yang bermakna pada usia jenis kelamin diabetes melitus hipertensi CHF CAD stroke hepatitis hiperlipidemia riwayat dilakukan AVF operator dan diameter arteri pra operasi Terdapat perbedaan yang bermakna pada AVF jenis radiosefalika dan brakiosefalika p 0 022 Didapatkan perbedaan maturasi yang bermakna pada diameter draining vein pasca operasi minggu pertama dan peningkatannya pada AVF tipe brakiosefalika p 0 034 dan p 0 041 dan radiosefalika p 0 012 dan p 0 011 Nilai cut off peningkatan diameter draining vein pasca operasi minggu pertama untuk batasan prediksi maturasi adalah 0 65 mm dengan sensitifitas sebesar 90 3 spesifisitas sebesar 85 7 Pada AVF tipe brakiosefalika nilai cut off adalah 0 45 mm dengan sensitifitas sebesar 95 8 spesifisitas sebesar 100 Pada AVF tipe radiosefalika nilai cut off adalah 1 00 mm dengan sensitifitas sebesar 85 7 spesifisitas sebesar 100 Simpulan Peningkatan diameter draining vein pasca operasi minggu pertama dapat dijadikan sebagai prediktor maturasi AVF ABSTRACT Introduction The main problem in ArterioVenous Fistula AVF is the failure of maturation Early detection for non mature AVF is needed making it possible to revise or create a new vascular access as soon as possible Preoperative vein diameter is considered to be an independent predictor factor in the maturation The purpose of this study was determining the early prediction of AVF maturation using the enlargement of draining vein diameter in the first week postoperative Methods Design of this study was cohort retrospective by taking patients medical records who underwent AVF surgery Vein diameter were measured preoperative and first week postoperative with Doppler ultrasound The enlargement of the first week draining vein diameter was associated with AVF maturation Results There was 38 patients with maturation rate was 81 6 There were no significant maturation differences on age sex diabetes mellitus hypertension CHF CAD stroke hepatitis hyperlipidemia AVF history operator and preoperative arterial diameter There was significant maturation difference in the radiocephalica and brachiocephalica AVF type p 0 022 There were significant maturation difference in first week postoperative draining vein diameter and it s increasement in brachiocephalica type p 0 034 and p 0 041 and radiocephalica type p 0 012 and p 0 011 Cut off value for first week postoperative draining vein diameter increasement in maturation prediction limitation is 0 65 mm with a sensitivity of 90 3 specificity of 85 7 For brachiocephalica type cut off value is 0 45 mm with a sensitivity of 95 8 specificity of 100 For radiocephalica type cut off value is 1 00 mm with a sensitivity of 85 7 specificity of 100 Conclusion First week postoperative draining vein diameter increasement can be used as predictors of AVF maturation ;Introduction The main problem in ArterioVenous Fistula AVF is the failure of maturation Early detection for non mature AVF is needed making it possible to revise or create a new vascular access as soon as possible Preoperative vein diameter is considered to be an independent predictor factor in the maturation The purpose of this study was determining the early prediction of AVF maturation using the enlargement of draining vein diameter in the first week postoperative Methods Design of this study was cohort retrospective by taking patients medical records who underwent AVF surgery Vein diameter were measured preoperative and first week postoperative with Doppler ultrasound The enlargement of the first week draining vein diameter was associated with AVF maturation Results There was 38 patients with maturation rate was 81 6 There were no significant maturation differences on age sex diabetes mellitus hypertension CHF CAD stroke hepatitis hyperlipidemia AVF history operator and preoperative arterial diameter There was significant maturation difference in the radiocephalica and brachiocephalica AVF type p 0 022 There were significant maturation difference in first week postoperative draining vein diameter and it s increasement in brachiocephalica type p 0 034 and p 0 041 and radiocephalica type p 0 012 and p 0 011 Cut off value for first week postoperative draining vein diameter increasement in maturation prediction limitation is 0 65 mm with a sensitivity of 90 3 specificity of 85 7 For brachiocephalica type cut off value is 0 45 mm with a sensitivity of 95 8 specificity of 100 For radiocephalica type cut off value is 1 00 mm with a sensitivity of 85 7 specificity of 100 Conclusion First week postoperative draining vein diameter increasement can be used as predictors of AVF maturation , Introduction The main problem in ArterioVenous Fistula AVF is the failure of maturation Early detection for non mature AVF is needed making it possible to revise or create a new vascular access as soon as possible Preoperative vein diameter is considered to be an independent predictor factor in the maturation The purpose of this study was determining the early prediction of AVF maturation using the enlargement of draining vein diameter in the first week postoperative Methods Design of this study was cohort retrospective by taking patients medical records who underwent AVF surgery Vein diameter were measured preoperative and first week postoperative with Doppler ultrasound The enlargement of the first week draining vein diameter was associated with AVF maturation Results There was 38 patients with maturation rate was 81 6 There were no significant maturation differences on age sex diabetes mellitus hypertension CHF CAD stroke hepatitis hyperlipidemia AVF history operator and preoperative arterial diameter There was significant maturation difference in the radiocephalica and brachiocephalica AVF type p 0 022 There were significant maturation difference in first week postoperative draining vein diameter and it s increasement in brachiocephalica type p 0 034 and p 0 041 and radiocephalica type p 0 012 and p 0 011 Cut off value for first week postoperative draining vein diameter increasement in maturation prediction limitation is 0 65 mm with a sensitivity of 90 3 specificity of 85 7 For brachiocephalica type cut off value is 0 45 mm with a sensitivity of 95 8 specificity of 100 For radiocephalica type cut off value is 1 00 mm with a sensitivity of 85 7 specificity of 100 Conclusion First week postoperative draining vein diameter increasement can be used as predictors of AVF maturation ]