International Urology and Nephrology

, Volume 49, Issue 5, pp 881–887 | Cite as

Calcification in arteriovenous fistula blood vessels may predict arteriovenous fistula failure: a 5-year follow-up study

  • Aleksandar Jankovic
  • Tatjana Damjanovic
  • Zivka Djuric
  • Jelena Marinkovic
  • Georg Schlieper
  • Petar Djuric
  • Jelena Tosic Dragovic
  • Ana Bulatovic
  • Milos Mitrovic
  • Jovan Popovic
  • Jürgen Floege
  • Nada Dimkovic
Nephrology - Original Paper
First Online:
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  • 176 Downloads

Abstract

Purpose

Arteriovenous fistula (AVF) is the preferred vascular access for hemodialysis. The impact of vascular calcification process on AVF survival remains unclear and results of several studies about this issue are controversial. In the light of the new knowledge about the different susceptibility for calcification process in different blood vessels, the aim of our study was to analyze whether the calcification of AVF-blood vessels may have an impact on AVF longevity.

Methods

The study included 90 patients, 49 males and 41 females, all of them Caucasians, with a mean age 62 ± 11 years, on regular hemodialysis for more than 1 year with patent primary AVFs. Vascular calcification in AVF-blood vessels or in the anastomotic region was detected using X-ray examination.

Results

Calcification in AVF-blood vessels was found in 62% of patients. Binary logistic regression analysis demonstrated that male gender, presence of diabetes mellitus and longer duration of AVF before calcification determination were associated with calcification of AVF-blood vessels. Using a Cox proportional hazard model adjusted for these standardized predicted values revealed that patients with present AVF-blood vessels calcification had increased risk to develop AVF failure with a hazard rate of 3.42 (95% confidence interval 1.00–11.67; P = 0.049).

Conclusions

Calcifications of AVF-blood vessels are found frequently among dialysis patients and may jeopardize the survival of native AVF. We suggested the local X-ray as simple and valid method for detection of patients that are at risk for AVFs failure which should be monitored more closely.

Keywords

Calcification AVF-blood vessels X-ray AVF survival 
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Notes

Compliance with ethical standards

Conflict of interest

None.

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Copyright information

© Springer Science+Business Media Dordrecht 2017

Authors and Affiliations

  • Aleksandar Jankovic
    • 1
  • Tatjana Damjanovic
    • 1
  • Zivka Djuric
    • 1
  • Jelena Marinkovic
    • 2
  • Georg Schlieper
    • 3
  • Petar Djuric
    • 1
  • Jelena Tosic Dragovic
    • 1
  • Ana Bulatovic
    • 1
  • Milos Mitrovic
    • 1
  • Jovan Popovic
    • 1
  • Jürgen Floege
    • 3
  • Nada Dimkovic
    • 1
    • 4
  1. 1.Clinical Department for Renal DiseasesZvezdara University Medical CenterBelgradeSerbia
  2. 2.Institute for Medical Statistics and Informatics, Faculty of MedicineUniversity of BelgradeBelgradeSerbia
  3. 3.Department of Nephrology and Clinical ImmunologyUniklinik RWTH AachenAachenGermany
  4. 4.Faculty of MedicineUniversity of BelgradeBelgradeSerbia

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