Association Between Atherosclerotic Cardiovascular Disease (ASCVD) Risk Score and Arteriovenous Fistula Failure in Patients on Maintenance Hemodialysis.

Autor: M G; Nephrology, Sri Ramachandra Institute of Higher Education and Research, Chennai, IND., Suresh S; Nephrology, Sri Ramachandra Institute of Higher Education and Research, Chennai, IND., Prakash A; Nephrology, Sri Ramachandra Institute of Higher Education and Research, Chennai, IND., G G; Nephrology, Sri Ramachandra Institute of Higher Education and Research, Chennai, IND., Elumalai RP; Nephrology, Sri Ramachandra Institute of Higher Education and Research, Chennai, IND., Shekar M; Nephrology, Sri Ramachandra Institute of Higher Education and Research, Chennai, IND., M J; Nephrology, Sri Ramachandra Institute of Higher Education and Research, Chennai, IND.
Jazyk: angličtina
Zdroj: Cureus [Cureus] 2024 Jun 13; Vol. 16 (6), pp. e62298. Date of Electronic Publication: 2024 Jun 13 (Print Publication: 2024).
DOI: 10.7759/cureus.62298
Abstrakt: Background: Arteriovenous fistula (AVF) is the vascular access of choice for hemodialysis in end-stage renal disease (ESRD) patients but has a significant failure rate. Atherosclerotic cardiovascular disease (ASCVD) is a major cause of mortality in ESRD patients. Atherosclerosis of the peripheral vessels may contribute to poor maturation of AVF leading to the exploration of the ASCVD score as a prognostic tool for AVF failure.
Methods: This study included 110 hemodialysis patients with AVFs and aimed to examine the association between ASCVD score and AVF failure. Participants were categorized into the presence of vascular access failure (N=12) and absence of vascular access failure (N=98), and demographic and clinical data were collected.  Results: The study comprised predominantly male patients (63.6%), with a notable prevalence of hypertension and diabetes. Twelve patients experienced AVF failure, with pseudoaneurysms and thrombosis being the predominant causes. The ASCVD risk group at intermediate and high stages exhibited a statistically significant risk (relative risk (RR)=1.403; 95% CI, 1.041-1.904) of AVF failure in comparison to the low and borderline ASCVD risk groups. There was no association of age, gender (male and female), body mass index (BMI), serum calcium, serum phosphorus, intact parathyroid hormone (iPTH), and serum albumin with AVF failure.
Conclusion: The ASCVD score emerges as a potential prognostic tool to identify dialysis patients at high risk of AVF failure, suggesting avenues for targeted interventions and improved patient care. However, limitations of the ASCVD risk estimator and study limitations, such as small sample size and absence of mortality data, warrant cautious interpretation and necessitate further exploration in larger patient populations.
Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Sri Ramachandra Institute of Ethical Committee issued approval CSP/22/FEB/105/49. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.
(Copyright © 2024, M et al.)
Databáze: MEDLINE
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