Keywords
Fístula arteriovenosa
Hemodiálisis
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Abstract
Objetivo: Analizar los factores de riesgo que conducen al fracaso de la hemodiálisis en pacientes con fístula arteriovenosa (FAV). Métodos: Esta revisión integrativa de la literatura se realizó mediante la búsqueda de artículos originales de los últimos 5 años en la Biblioteca Nacional de Medicina (PubMed), la Literatura Latinoamericana y del Caribe en Ciencias de la Salud (LILACS) y la Biblioteca Electrónica Científica en Línea (Scielo). Los descriptores en Ciencia y Salud (DeCS) fueron "Factores de Riesgo", "Hemodiálisis" y "Fístula Arteriovenosa", asociados con el operador booleano "AND". Se encontraron 170 artículos, de los cuales 20 fueron seleccionados, excluyendo aquellos que no cumplían con los criterios establecidos. Resultados: La evaluación de los factores de riesgo es esencial para prevenir el fracaso. En las mujeres, los diámetros arteriales más pequeños dificultan la maduración de la fístula. La hipertensión causa diferencias en la presión del pulso, lo que provoca daño endotelial, inflamación y aumento de la permeabilidad vascular. La hiperfosfatemia puede desencadenar vías apoptóticas, acelerando el daño, y los niveles elevados de PCR contribuyen a la hipercoagulabilidad. Consideraciones finales: La FAV es crucial para los pacientes en hemodiálisis, ya que permite un acceso seguro y eficaz al sistema circulatorio. El manejo de factores de riesgo como el sexo femenino, la edad avanzada, la hipertensión, la hiperfosfatemia y la PCR elevada es esencial para prolongar la duración de la fístula, mejorar la calidad de vida y reducir las fallas.
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