Effect of radial artery calcification on survival of arteriovenous fistula and the patients in end?stage renal disease patients / 中华肾脏病杂志

ABSTRACT

Objective To investigate the effect of radial artery calcification (RAC) on survival of arteriovenous fistula (AVF) and the patients in end?stage renal disease. Methods Adult ESRD patients undergoing AVF surgery between January 2013 and January 2016 at the Eighth Affiliated Hospital of Sun Yat?sen University were enrolled in this study. The clinical and biochemical data were collected. Segment of radial artery were obtained from the operation of AVF. RAC at the site of anastomotic were observed by alizarin red S and hematoxylin and eosin staining. According to RAC, the patients were divided into calcification group and non?calcification group. Kaplan?Meier analysis was performed to analyze the survival rates of the two groups, and Cox proportional hazards regression——model was used to estimate the risk factors of AVF dysfunction and all?cause mortality in ESRD patients. Results Among 180 cases of ESRD patients, 38 cases (21.1％) were developed RAC at the site of anastomotic in different degrees. Compared with the non?calcification groups, the calcification groups had a longer dialysis vintage, a higher proportion of diabetes and higher level of HbAlc (all P﹤0.05). Binary logistic regression analysis showed that dialysis vintage>5 years and diabetics were two independent risk factors of RAC at the site of anastomotic. Kaplan?Meier survival analysis demonstrated that there were no statistical differences between two groups in AVF survival (χ2=0.009, P=0.926). Calcification group had higher all?cause mortality than non?calcification groups (χ2=9.809, P=0.002). Multivariate Cox regression analysis demonstrated that homocysteine was independent risk factor for AVF dysfunction (HR=1.027, 95％CI 1.003-1.051, P=0.027). Age was independent risk factor for all?cause mortality (HR=1.078, 95％CI 1.035-1.122, P=0.000). Conclusions Dialysis vintage>5 years and diabetes were two independent risk factors of RAC at the site of anastomotic in ESRD patients. RAC at the site of anastomotic had no effect on AVF survival, but increased all?cause mortality.