Preoperative Systemic Immune-Inflammation Index Is Independently Associated with Distal Arteriovenous Fistula Failure

Area of Science:

• Vascular Surgery
• Nephrology
• Inflammation Research

Background:

• Distal arteriovenous fistula (AVF) failure is a significant clinical challenge, impacting hemodialysis access.
• Preoperative assessment of vascular anatomy alone may not fully predict AVF success.
• Systemic inflammation is increasingly recognized as a factor in surgical outcomes.

Purpose of the Study:

• To evaluate the association between preoperative systemic immune-inflammation index (SII) and distal AVF failure.
• To determine if SII is an independent predictor of AVF failure after adjusting for anatomical and clinical factors.

Main Methods:

• Retrospective single-center study of 209 patients undergoing distal AVF creation.
• Preoperative vascular anatomy assessed by duplex ultrasonography.
• Systemic inflammatory status evaluated using the SII; logistic regression analyses performed for outcome prediction.

Main Results:

• Distal AVF failure occurred in 19.6% of patients.
• Multivariable analysis revealed smaller distal vein diameter and higher preoperative SII were independently associated with increased AVF failure risk.
• Advanced age was associated with a lower likelihood of AVF failure.

Conclusions:

• Preoperative SII is an independent predictor of distal AVF failure in an anatomically selected cohort.
• Favorable vascular anatomy remains the strongest determinant of AVF outcome.
• SII may serve as a valuable complementary tool for risk stratification in AVF planning.