Elevated PTH Tied to Arteriovenous Fistula Maturation Failure

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Secondary hyperparathyroidism may have a detrimental effect on successful arteriovenous fistula creation, researcher says.
Secondary hyperparathyroidism may have a detrimental effect on successful arteriovenous fistula creation, researcher says.

NEW ORLEANS—Elevated parathyroid hormone (PTH) levels may increase a patient's risk of arteriovenous fistula (AVF) maturation failure, according to findings presented at Kidney Week 2017.

Of 408 patients (mean age 57 years, 56% male) who had an AVF created for maintenance hemodialysis during 2004 to 2017 at his hospital, 59 (14.5%) experienced maturation failure, Chung-te Liu, MD, of Wanfang Hospital in Taipei, reported. These patients were significantly more likely to have diabetes, elevated glucose, and increased PTH. Other markers of chronic kidney disease mineral bone disorder (CKD-MBD), such as calcium and phosphorus, showed no association.

After multivariate logistic regression analysis, only PTH significantly correlated with maturation failure, in keeping with results from previous studies. “This finding indicates that secondary hyperparathyroidism may have a detrimental effect on successful rate of AVF creation,” Dr Liu told Renal & Urology News. “It might be helpful to lower PTH levels during CKD stages 4 to 5 to improve the AVF maturation rate.”

Dr Liu and his team will be conducting basic research studies to test their hypothesis and better understand the possible mechanisms behind PTH and AVF maturation failure.

Reference

Liu CT. CKD-Mineral bone fisorder and risk of maturation failure in hemodialysis arteriovenous fistula. Presented in poster format at Kidney Week 2017 in New Orleans (Oct. 31 to Nov. 5). Abstract TH-PO766.

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