Kidney Res Clin Pract.  2015 Mar;34(1):41-46. 10.1016/j.krcp.2015.02.001.

Hyperphosphatemia is associated with patency loss of arteriovenous fistula after 1 year of hemodialysis

• Moon JY
• Lee HM
• Lee SH
• Lee TW
• Ihm CG
• Jo YI
• Han SW
• Shin SG

• KMID: 2381512
• DOI: http://doi.org/10.1016/j.krcp.2015.02.001

Abstract

BACKGROUND
The patency of arteriovenous access is important for stable and effective hemodialysis, and long-term technical survival is best achieved with a native arteriovenous fistula (AVF). However, maintaining AVF patency remains a challenge. This study was designed to determine the independent prognostic factors for AVF patency according to hemodialysis duration.
METHODS
The primary study end point was unassisted patency of the AVF, which was defined as the time from the first fistula surgery to the first AVF failure. AVF failure was defined as an event that required percutaneous intervention or surgery to revise or replace the fistula, which occurred at least 2 months after fistula formation.
RESULTS
We enrolled 478 patients with a mean age of 55.5+/-14.0 years, and mean duration of dialysis was 2.5+/-2.1 years. There were 109 cases (22.8%) of AVF failure. The factors related to AVF patency differed according to hemodialysis duration. Using a Cox-adjusted model, we observed a significant correlation between the incidence of AVF failure and diabetes within the initial 12 months of hemodialysis. Uncontrolled hyperphosphatemia (mean serum phosphorus>5.5 mg/dL during hemodialysis) was associated with patency loss of AVF after 1 year of hemodialysis.
CONCLUSION
Various factors were associated with the development of patency loss of AVF as hemodialysis duration differed, and a preventive role of hyperphosphatemia control in AVF survival needs further clinical study.

Keyword

Arteriovenous fistula; Hemodialysis; Hyperphosphatemia

MeSH Terms

Arteriovenous Fistula*
Dialysis
Fistula
Humans
Hyperphosphatemia*
Incidence
Renal Dialysis*