Blood monocyte count may be a predictor of vascular access failure in hemodialysis patients

It has been reported that an increase in the counts of white blood cells (WBC) and their subpopulations is an independent predictor of atherosclerotic events and mortality. On the other hand, vascular access (VA) stenosis is caused by a progressive development of neointimal hyperplasia. We examined the relationship between VA failure and counts of peripheral WBC and their subpopulations in hemodialysis (HD) patients. The study population consisted of 82 patients undergoing regular HD. Twenty-two patients, who were unstable, were excluded from the study. After one year, we examined the relationship between VA failure and the counts of peripheral WBC and their subpopulations. In the follow-up period, 21 patients had complicated VA failure. The counts of WBC, neutrophils, lymphocytes, eosinophils, and basophils did not show a significant difference, but a monocyte count of ≥ 400/μL was shown to indicate a high probability of VA failure. Logistic regression analysis revealed that monocyte count was an independent risk factor of VA failure. The peripheral blood monocyte count may be a predictor of VA failure in HD patients.