https://scholars.lib.ntu.edu.tw/handle/123456789/558481
標題: | Association of low serum fetuin A levels with poor arteriovenous access patency in patients undergoing maintenance hemodialysis | 作者: | Chen H.-Y. Chiu Y.-L. Chuang Y.-F. Hsu S.-P. Pai M.-F. CHUN-FU LAI Yang J.-Y. Peng Y.-S. TUN-JUN TSAI KWAN-DUN WU |
公開日期: | 2010 | 卷: | 56 | 期: | 4 | 起(迄)頁: | 720-727 | 來源出版物: | American Journal of Kidney Diseases | 摘要: | Background: Fetuin A, a predictor of mortality in dialysis patients, is associated with vascular calcification and atherosclerosis in hemodialysis (HD) patients. Whether it predicts arteriovenous (AV) access patency is unknown. This study aimed to investigate the association between fetuin A and AV access patency in HD patients. Study Design Prospective observational study. Setting & Participants 238 prevalent HD patients (127 women and 111 men; mean age, 60 ± 12 years) were followed up for AV access patency for 32 months. Predictors Tertiles of baseline circulating fetuin A levels, corresponding to 0.15-0.25, 0.26-0.32, and 0.33-0.51 g/L. Outcome The major outcome was loss of unassisted AV access patency, defined as AV access thrombosis or need for intervention. Measurements Fetuin A and other markers of inflammation. Results 100 patients had loss of AV access patency (42%) on follow-up. Patients in the lowest fetuin A tertile had the worst AV access patency (log-rank test, χ2 = 8.68; P = 0.01). Using Cox proportional hazards regression with patients in the lowest fetuin A tertile as reference, patients in the intermediate tertile had an HR of 0.49 (95% CI, 0.29-0.82), whereas those in the highest fetuin A tertile had an HR of 0.43 (95% CI, 0.25-0.75) for loss of AV access patency. Similarly, considering patients using AV fistulas or grafts separately, patients in the highest fetuin A tertile had less risk of losing AV access patency than patients in the other tertiles (HR, 0.40 [95% CI, 0.19-0.84] for patients with AV fistulas and HR, 0.25 [95% CI, 0.10-0.65] for patients with AV grafts). Limitations Focus on the patency of prevalent rather than new AV access in maintenance hemodialysis patients. Conclusions Fetuin A deficiency is associated with a higher risk of loss of AV access patency in either native AV fistulas or AV grafts in HD patients. ? 2010 National Kidney Foundation, Inc. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-77956892274&doi=10.1053%2fj.ajkd.2010.06.015&partnerID=40&md5=6cff3bbfed45a5738c1cbb4c027d6627 https://scholars.lib.ntu.edu.tw/handle/123456789/558481 |
ISSN: | 0272-6386 | DOI: | 10.1053/j.ajkd.2010.06.015 | SDG/關鍵字: | acetylsalicylic acid; antihypertensive agent; antithrombocytic agent; biological marker; clopidogrel; colecalciferol; dipyridamole; fetuin A; hydroxymethylglutaryl coenzyme A reductase inhibitor; pentoxifylline; recombinant erythropoietin; warfarin; alpha fetoprotein; biological marker; adult; aged; anemia; arteriovenous access patency; arteriovenous fistula; arteriovenous graft; article; atherosclerosis; clinical assessment; diabetes mellitus; female; hazard ratio; hemodialysis; hemodialysis patient; human; hypertension; infection; inflammation; intervention study; kidney failure; major clinical study; male; observational method; outcome assessment; prevalence; prospective study; protein blood level; risk factor; treatment outcome; vascular access; vascular patency; vein graft; vein thrombosis; arteriovenous shunt; blood; confidence interval; follow up; indwelling catheter; Kaplan Meier method; Kidney Failure, Chronic; middle aged; proportional hazards model; renal replacement therapy; risk assessment; sensitivity and specificity; Aged; alpha-Fetoproteins; Arteriovenous Shunt, Surgical; Biological Markers; Catheters, Indwelling; Confidence Intervals; Female; Follow-Up Studies; Humans; Kaplan-Meiers Estimate; Kidney Failure, Chronic; Male; Middle Aged; Proportional Hazards Models; Prospective Studies; Renal Dialysis; Risk Assessment; Sensitivity and Specificity; Vascular Patency; Aged; alpha-Fetoproteins; Arteriovenous Shunt, Surgical; Biological Markers; Catheters, Indwelling; Confidence Intervals; Female; Follow-Up Studies; Humans; Kaplan-Meier Estimate; Kidney Failure, Chronic; Male; Middle Aged; Proportional Hazards Models; Prospective Studies; Renal Dialysis; Risk Assessment; Sensitivity and Specificity; Vascular Patency |
顯示於: | 醫學系 |
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