A Meta-Analysis of Risk Factors for Restenosis following Percutaneous Transluminal Angioplasty in Arteriovenous Fistulas of Maintenance Hemodialysis Patients.

BACKGROUND

To systematically evaluate risk factors for restenosis after percutaneous transluminal angioplasty (PTA) in arteriovenous fistulas (AVFs) of maintenance hemodialysis (MHD) patients.

METHODS

This systematic review, prospectively registered on PROSPERO (CRD420250631715), identified studies investigating factors influencing AVF patency after PTA in MHD patients. Databases including PubMed, Embase, CNKI, CBM, and the Chinese Scientific Journal Database were searched from inception to January 2025. Study quality was assessed using the Newcastle-Ottawa Scale, and meta-analyses were performed using STATA 18.0.

RESULTS

Fourteen studies involving 2,257 participants were included in the meta-analysis. The pooled results demonstrated diabetes mellitus (hazard ratio = 1.18, 95% confidence interval (CI): 1.03-1.36, P = 0.016), upper-arm AVF location (odds ratio (OR) = 1.67, 95% CI: 1.33-2.10, P < 0.0001), stenosis length >2 cm (OR = 1.50, 95% CI: 1.11-2.02, P = 0.008), and multiple stenosis lesions (OR = 1.53, 95% CI: 1.24-1.89, P < 0.0001) as significant risk factors for restenosis following PTA in MHD patients.

CONCLUSION

Age, body mass index, sex, and AVF vintage were not identified as significant risk factors for restenosis. However, diabetes mellitus, upper-arm AVF location, stenosis length >2 cm, and multiple stenosis lesions emerged as statistically significant predictors.