Atrial Fibrillation linked to Vascular access Thrombosis in Chronic Hemodialysis Patients

Aim: Atrial fibrillation (AF) is characterized by the development of thromboembolic events and is more prevalent among end-stage renal disease patients than in the general population. Vascular access thrombosis (VAT) is a major morbidity in chronic hemodialysis (HD) patients; however, the associatio...

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Bibliographic Details
Published in:Journal of Atherosclerosis and Thrombosis 2011, Vol.18(6), pp.448-453
Main Authors: Chou, Che-Yi, Chen, Jan-Yow, Liu, Jiung-Hsiun, Liu, Yao-Lung, Lin, Hsin-Hung, Yang, Ya-Fei, Wang, Shu-Ming, Kuo, Huey-Liang, Huang, Chiu-Ching
Format: Article
Language:English
Subjects:
Atrial Fibrillation - etiology
C-Reactive Protein - metabolism
ESRD
Female
Humans
Kidney Failure, Chronic - therapy
Male
Middle Aged
Renal Dialysis - adverse effects
Retrospective Studies
Risk Factors
VAT
Venous Thrombosis - etiology
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Summary:Aim: Atrial fibrillation (AF) is characterized by the development of thromboembolic events and is more prevalent among end-stage renal disease patients than in the general population. Vascular access thrombosis (VAT) is a major morbidity in chronic hemodialysis (HD) patients; however, the association between AF and VAT is unknown. Methods: We retrospectively reviewed chronic HD patients with functional vascular access between 1997 and 2006. The association between AF and the development of VAT was analyzed using Kaplan-Meier analysis and multivariate Cox proportional hazards regression. Results: A total of 568 chronic HD patients, including 55 (9.7%) patients with AF, were reviewed and 154 (27.1%) patients developed at least one episode of VAT. Patients with AF had worse VAT-free survival than patients without AF (p< 0.001). In Cox regression, age, type of vascular access, atrial fibrillation, diabetes, hypertension, and C-reactive protein were independently linked to the development of VAT ( p= 0.049, < 0.001, < 0.001, 0.001, 0.028 and 0.045). The hazard ratios were 2.1 (95% CI: 1.00-1.03) for arteriovenous graft, 2.47 (95% CI: 1.66-3.69) for AF, 1.72 (95% CI: 1.25-2.39) for diabetes and 1.09 (95% CI: 1.00-1.18) for serum C-reactive protein (every 1 mg/dL increase), respectively. Conclusion: Atrial fibrillaiton is linked to the development of vascular access thrombosis in chronic hemodialysis patients and is independent of traditional VAT risk factors.
ISSN:1340-3478
1880-3873
DOI:10.5551/jat.6296