Arterio-Venous Fistula Calcifications-Risk Factors and Clinical Relevance

Area of Science:

• Nephrology
• Vascular Surgery
• Radiology

Background:

• Arterio-venous fistulas (AVFs) are the preferred vascular access for hemodialysis (HD).
• AVF calcifications are an understudied complication, despite HD patients' predisposition to extraosseous calcifications.
• Understanding AVF calcification prevalence and impact is crucial for managing dialysis patients.

Purpose of the Study:

• To determine the prevalence of AVF calcifications in maintenance HD patients.
• To identify risk factors associated with AVF calcifications.
• To evaluate the 5-year impact of AVF calcifications on fistula functionality and patient mortality.

Main Methods:

• A 5-year prospective study involving 161 maintenance HD patients.
• Collection of baseline data: vascular access history, comorbidities, demographics, SGA, and biochemical parameters.
• AVF ultrasound assessment of blood flow, calcifications, stenoses, and aneurysms.

Main Results:

• AVF calcification prevalence was 39%.
• Univariate analysis linked calcifications to other AVF complications, longer AVF/HD vintage, and higher serum calcium/PTH.
• Multivariate analysis identified longer HD vintage and higher calcium as independent predictors of AVF calcifications.

Conclusions:

• AVF calcifications are frequent in HD patients.
• AVF calcifications did not significantly affect 5-year fistula patency.
• AVF calcifications were not associated with increased 5-year mortality risk.