Objective To observe the relationship between aortic calcification and primary patency rate of autologous internal fistula in maintenance hemodialysis patients, and to explore the possibility of predicting the dysfunction of autologous internal fistula by aortic calcification score. Methods A total of 88 patients who underwent autologous arteriovenous fistula and hemodialysis for the first time in our hospital were selected. Their abdominal aortic calcification index (ACI) at the time of internal fistula surgery was recorded. According to the results of ACI, the patients were divided into high calcification group and low calcification group. The primary patency rate of autologous internal fistula within 3 years was observed in the two groups. Results Seventy patients (93.33%) had different degrees of aortic calcification, including 35 patients in the high calcification group (ACI ≥10%). During the 3-year follow-up period, a total of 31 patients developed various internal fistula dysfunctions, including thrombosis in 17 cases and internal fistula stenosis in 10 cases. After 12, 24 and 36 months, the primary patency rates of internal fistulas were 92.5%, 85% and 76.9% in low calcification group, and were 88.6%, 68.5% and 45.9% in high calcification group (χ2=7.182, P=0.007). COX regression showed that autologous internal fistula dysfunction was related to ACI (HR=5.788, 95% CI:1.488～22.514, P=0.011). Conclusions Higher ACI is related to the dysfunction of autologous arteriovenous fistula within 3 years. Internal fistula function dysfunction should be monitored and treated earlier in patients with higher ACI to prolong the survival of internal fistula.
[1]Gameiro Joana, Ibeas Jose.Factors affecting arteriovenous fistula dysfunction: A narrative review[J].J Vasc Access, 2020, 21(2):134-147
[2]Christina M Wyatt, Tilman B Drueke.Vascular calcification in chronic kidney disease: here to stay?[J].Kidney Int, 2017, 92(2):276-278
[3]A.Jankovic,TDamjanovic,Z. Djuric,et al.Impact of vascularcalcifications on arteriovenous fistula survival in hemodialysis patients:afive-year follow-up.[J].Nephron, 2015, 129(4):247-252
[4]Yosuke Tatami, Yoshinari Yasuda, Susumu Suzuki, et al.Impact of abdominal aortic calcification on long-term cardiovascular outcomes in patients with chronic kidney disease[J].Atherosclerosis, 2015, 243(2):349-355
[5]Lee T, Mokrzycki M, Moist L, et al.Standardized definitions for hemodialysis vascular access[J].Semin Dial, 2011, 24(5):515-524
[6]Peeters Mieke J, van den Brand Jan Ajg, van Zuilen Arjan D, et al.Abdominal aortic calcification in patients with CKD[J].J Nephrol, 2017, 30(1):109-118
[7]Muhammad A Siddiqui, Suhel Ashraff, Thomas Carline.Maturation of arteriovenous fistula: Analysis of key factors[J].Kidney Res Clin Pract, 2017, 36(4):318-328
[8]Choi SJ, Yoon HE, Kim YS, et al.Pre-existing arterial micro-calcifi-cation predicts primary unassisted arteriovenous fistula failure inincident hemodialysis patients[J].Semin Dial, 2015, 28(6):665-669
[9]Allon M, Litovsky S, Young CJ, et al.Correlation of pre-existing vascularpathology with arteriovenous graft outcomesin hemodialysis patients[J].Am J Kidney Dis., 2013, 62(6):1122-1129
[10]Lyu Beini, Banerjee Tanushree, Scialla Julia, etal.Vascular Calcification Markers and Hemodialysis Vascular Access Complications.[J] .[J].Am J Nephrol, 2018, 48:330-338
[11]Allon Michael, Robbin Michelle, Umphrey Heidi, et al.Preoperative arterial microcalcification and clinical outcomes of arteriovenous fistulas for hemodialysis[J].Am J Kidney Dis., 2015, 66(1):84-90
[12]NasrAllah Mohamed M, Nassef Amr, Elshaboni Tarik H, et al.Comparing different calcification scores to detect outcomes in chronic kidney disease patients with vascular calcification.[J].[J].Int J Cardiol, 2016, 220:884-889
[13]Monroy-CuadrosMauricio, Yilmaz Serdar, Salazar-Ba?uelos Anastasio, et al.Risk factors associated with patency loss of hemodialysis vascular access within 6 months[J].Clin J Am Soc Nephrol, 2010, 5(10):1787-92
[14]蔡宏, 严玉澄, 陆任华等.腹主动脉钙化评分可预估血液透析患者的冠状动脉钙化程度[J].中国血液净化, 2013, 12(4):189-194
[15]Daniel Bos 1, M Arfan Ikram, Suzette E Elias-Smale, et al.Calcification in major vessel beds relates to vascular brain disease[J].Arterioscler Thromb Vasc Biol, 2011, 31(10):2331-7
[16]Hyun Gyung Kim, Sun Cheol Park, Soo Lim Lee, et al.Arterial micro-calcification of vascular access is associated with aortic arch calcification and arterial stiffness inhemodialysis patients[J].Semin Dial, 2013, 26(2):216-22
[17]Simard T, Hibbert B, Ramirez FD, et al.The evolution of coronary stents: a brief review[J].Can J Cardiol, 2014, 30(1):35-45
[18]Lehoux S, Castier Y, Tedgui A.Molecular mechanisms ofthe vascular responses to haemodynamic forces[J].J Intern Med, 2006, 259(4):381-392
[19]Davies Peter F, Civelek Mete, Fang Yun, et al.The atherosusceptible endothelium: endothelial phenotypes in complex haemodynamic shear stress regions in vivo[J].Cardiovasc Res, 2013, 99(2):315-27
[20]Borissoff Julian I, Joosen Ivo A, Versteylen Mathijs O, et al.Accelerated in vivo thrombin formation independently predicts the presence and severity of CT angiographic coronary atherosclerosis[J].JACCCardiovascImaging, 2012, 5(12):1201-1210
[21]Hagstr?m Emil, Micha?lsson Karl, Melhus H?kan et al.Plasma-parathyroid hormone is associated with subclinical and clinical atherosclerotic disease in 2 community-based cohorts[J].ArteriosclerThrombVascBiol, 2014, 34(7):1567-1573
[22]Yap Yit-Sheung, Ting Kai-Ting, Chi Wen-Che, et al.Aortic Arch Calcification Predicts Patency Loss of Arteriovenous Fistula in End-Stage Renal Disease Patients.[J].Sci Rep, 2016, 6:24943-
[23]Liu JH, Lin PW, Liu YL, et al.Comparison of classical and non-classicalcardiovascular risk factors influencing the patency of native arteriovenous fistulas afterpercutaneous transluminal angioplasty therapy among haemodialysis patients[J].PostgradMed J, 2007, 83(982):547-551
[24]Kim Sun Chul, Kim Hye Won, Oh Se Won, et al.Low iPTH can predict vascular and coronary calcifications in patients undergoing peritoneal dialysis[J].Nephron Clin Pract, 2011, 117(2):113-119
[25]Kordzadeh Ali, Tokidis Evripidis, Askari Alan, et al.The independent association of preoperative serum albumin on the functional maturation of radiocephalic arteriovenous fistulae[J].J Vasc Access., 2017, 18(2):148-152
[26]Ju-Young Moon, Hyae Min Lee, Sang-Ho Lee, et al.Hyperphosphatemia is associated with patency loss of arteriovenous fistula after 1 year of hemodialysis[J].Kidney Res Clin Pract, 2015, 34(1):41-6
