High serum phosphorus levels may be a risk factor for primary failure of arteriovenous fistulas (AVFs), according to new research.
In 482 patients (67% male; mean age 65 years), 622 AVFs were created, of which 27% had primary failure. A univariate analysis showed high blood pressure, statins, antiplatelet therapy, fibrinogen, serum phosphorus, C-reactive protein, triglycerides, ferritin, and age were significant factors in primary failure.
In multivariate analysis, high serum phosphorus levels significantly correlated with 22% increased odds of vascular access thrombosis, Paz Castro Fernandez, MD, and colleagues from Hospital General Ciudad Real in Spain reported in a 2021 World Congress of Nephrology abstract published in Kidney International Reports. Conversely, high blood pressure and statin use significantly correlated with 54% and 42% decreased odds of vascular access thrombosis, respectively.
High serum phosphorus levels appear to be an independent risk factor for primary failure of AVFs, whereas high blood pressure and preoperative antiplatelet therapy appear to be protective, according to the investigators. Of the cohort, 48.7% received antiplatelet therapy and 15.6% anticoagulation prior to the creation of the AVF.
Of the AVF procedures, 86.8% were autologous. The most common etiologies of chronic kidney disease in the cohort were diabetic nephropathy (30.2%), unknown etiology (18%), and glomerular (16.6%). High blood pressure was present in 91.2% of patients and diabetes in 47.9%.
Castro Fernandez P, Piccone Saponara L, Uribe Heredia NG, et al. Mineral bone disease associated with chronic kidney disease. Does it influence in primary permeability after the creation of vascular access for hemodialysis? Kidney Int Rep 6(4):S249-S250. Abstract POS-567. doi:10.1016/j.ekir.2021.03.596