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Assessment of Vascular Function in Patients With Chronic Kidney Disease
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Association of Permanent Vascular Access Dysfunction with Subsequent Risk of Cardiovascular Disease: A

Tung-Wei Hung1,2,3, Sheng-Wen Wu1,2,3, Jeng-Yuan Chiou4

  • 1School of Medicine, Chung Shan Medical University, Taichung 402306, Taiwan.

Journal of Personalized Medicine
|April 23, 2022
PubMed

Insights

Permanent vascular access dysfunction in hemodialysis patients significantly increases the risk of developing cardiovascular disease (CVD). This finding highlights the importance of monitoring vascular access to improve patient outcomes and reduce hospitalizations.

Area of Science:

  • Nephrology
  • Cardiovascular Medicine
  • Public Health

Background:

  • Functional permanent vascular access (VA) is crucial for hemodialysis.
  • Vascular access dysfunction is a significant cause of morbidity and hospitalization in hemodialysis patients.
  • Cardiovascular disease (CVD) is the leading cause of mortality in patients undergoing chronic hemodialysis, but its association with VA dysfunction is unclear.

Purpose of the Study:

  • To investigate the association between dialysis VA dysfunction and the risk of developing CVD in hemodialysis patients.
  • To analyze nationwide population-based cohort data to assess this relationship.

Main Methods:

  • A nationwide population-based cohort study using data from Taiwan's National Health Insurance Research Database (2000-2013).
  • Included were end-stage renal disease patients aged ≥20 years who received permanent VA construction and hemodialysis (2000-2007).
  • Compared 197 patients with permanent VA dysfunction (test group) to 100 patients with non-permanent VA dysfunction (control group), assessing CVD incidence (ICD-9-CM 410-414, 430-437).

Main Results:

  • The adjusted hazard ratio of CVD for the VA dysfunction group was 3.05 (95% CI: 1.14-8.20) compared to the control group.
  • Kaplan-Meier analysis showed a higher cumulative incidence of CVD in the permanent VA dysfunction group.
  • Permanent VA dysfunction was significantly associated with an increased risk of subsequent CVD.

Conclusions:

  • Permanent vascular access dysfunction is a significant risk factor for subsequent cardiovascular disease in hemodialysis patients.
  • Monitoring and maintaining vascular access function may be critical in mitigating CVD risk.
  • Further research into the mechanisms linking VA dysfunction and CVD is warranted.

Keywords:
arteriovenous fistulaarteriovenous graftscardiovascular diseasedialysispermanent vascular access

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