The Correlation Between Abdominal Aortic Calcification And Arteriovenous Fistula Dysfunction In Maintenance Hemodialysis Patients

Objective To explore the clinical characteristics of abdominal aortic calcification in maintenance hemodialysis(MHD)patients with arteriovenous fistula(AVF)dysfunction,further to evaluate whether the presence of abdominal aortic calcification is correlated with AVF dysfunction in MHD patients.Methods Clinical data of patients undergoing hemodialysis more than 3 months in Blood Purification Department of Zhongda Hospital in 3 years were retrospectively studied.According to the inclusion criteria and exclusion criteria,collect basic information and related laboratory test results from these included cases.Two radiologists,who were blinded to the AVF functions,diagnose the vascular calcifications on computed tomography(CT)of abdominal aorta.Factors related to AVF dysfunction were analyzed by binary logistic regression analysis.There is a statistical significance with P<0.05.Results 1.114 MHD patients were included in this study,including 60 males and 54 females.Mean age of these patients was 61.09±14.49 years.2.The percent of AVF dysfunction is 50.9%in all included cases.Compared with the AVF normal function group,HDL,ApoA1 and BUN were significantly higher in the AVF dysfunction group(P<0.05).3.101 cases(88.6%)had abdominal aortic calcification of different degrees,49.5%for the mild calcification group and 50.5%for the severe calcification group.There is a significant difference in age,history of CKD,the presence of DM,TC,ApoB and Ca between the abdominal aortic calcification and non-calcification group(P<0.05).Compared with the mild abdominal aortic calcification group,BMI,history of CKD,dialysis duration are significantly higher in the severe abdominal aortic calcification group(P<0.05).4.Spearman analysis suggests that,AVF dysfunction was positively correlated with ApoA1(r = 0.282,P = 0.002),BUN(r = 0.241,P = 0.010)and the presence of abdominal aortic calcification(r =0.209,P = 0.025).5.Logistic regression analysis showed that the probability of AVF dysfunction in the severe abdominal calcification group was 4.7 times[OR = 4.676,95%CI(1.073-20.374)]higher than that in the non-calcification group,whereas there was no significant difference between the mild calcification group and the non-calcification group.The presence of severe abdominal aortic calcification is an independent risk factor for AVF dysfunction.Conclusions The presence of abdominal aortic calcification is common in MHD patients with AVF dysfunction.There is a correlation between abdominal aortic calcification and AVF dysfunction in MHD patients.The presence of severe abdominal aortic calcification is an independent risk factor for AVF dysfunction.