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Pre‐existing Arterial Micro‐Calcification Predicts Primary Unassisted Arteriovenous Fistula Failure in Incident Hemodialysis Patients
Author(s) -
Choi Su Jin,
Yoon Hye Eun,
Kim Young Soo,
Yoon Sun Ae,
Yang Chul Woo,
Kim YongSoo,
Park Sun Cheol,
Kim Young Ok
Publication year - 2015
Publication title -
seminars in dialysis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.899
H-Index - 78
eISSN - 1525-139X
pISSN - 0894-0959
DOI - 10.1111/sdi.12365
Subject(s) - medicine , hemodialysis , arteriovenous fistula , incidence (geometry) , cardiology , proportional hazards model , risk factor , surgery , pathological , calcification , radiology , physics , optics
Vascular access micro‐calcification is a risk factor for cardiovascular morbidity and mortality in hemodialysis ( HD ) patients but its influence on vascular access patency is still undetermined. Our study aimed to determine the impact of arterial micro‐calcification ( AM iC) on the patency of vascular access in HD patients. One‐hundred fourteen HD patients receiving arteriovenous fistula ( AVF ) operation were included in this study. During the operation, we obtained partial arterial specimen and performed pathological examination by von Kossa stain to identify AM iC. We compared primary unassisted AVF failure within 1 year between positive and negative AM iC groups, and performed Cox regression analysis for evaluating risk factor of AVF failure. The incidence of AM iC was 37.7% and AVF failure occurred in 45 patients (39.5%). The AVF failure rate within 1 year was greater in the positive AM iC group than those in the negative AM iC group (53.5% vs. 31.0%, p = 0.02). Kaplan–Meier analysis showed that the positive AM iC group had a lower AVF patency rate than the negative AM iC group ( p = 0.02). The presence of AM iC was an independent risk factor for AVF failure. In conclusion, preexisting AM iC of the vascular access is associated with primary unassisted AVF failure in incident HD patients.