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

  • Nephrology - Original Paper
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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.

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Authors and Affiliations

  1. Clinical Department for Renal Diseases, Zvezdara University Medical Center, Dimitrija Tucovica 161, 11000, Belgrade, Serbia

    Aleksandar Jankovic, Tatjana Damjanovic, Zivka Djuric, Petar Djuric, Jelena Tosic Dragovic, Ana Bulatovic, Milos Mitrovic, Jovan Popovic & Nada Dimkovic

  2. Institute for Medical Statistics and Informatics, Faculty of Medicine, University of Belgrade, Belgrade, Serbia

    Jelena Marinkovic

  3. Department of Nephrology and Clinical Immunology, Uniklinik RWTH Aachen, Aachen, Germany

    Georg Schlieper & Jürgen Floege

  4. Faculty of Medicine, University of Belgrade, Belgrade, Serbia

    Nada Dimkovic

Authors
  1. Aleksandar Jankovic
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  2. Tatjana Damjanovic
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  3. Zivka Djuric
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  4. Jelena Marinkovic
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  5. Georg Schlieper
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  7. Jelena Tosic Dragovic
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  11. Jürgen Floege
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Correspondence to Aleksandar Jankovic.

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Jankovic, A., Damjanovic, T., Djuric, Z. et al. Calcification in arteriovenous fistula blood vessels may predict arteriovenous fistula failure: a 5-year follow-up study. Int Urol Nephrol 49, 881–887 (2017). https://doi.org/10.1007/s11255-017-1515-0

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