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Abstract: FR-PO717

Effect of Aspirin Resistance and Mean Platelet Volume on Vascular Access Failure in Hemodialysis Patients

Session Information

Category: Dialysis

  • 704 Dialysis: Vascular Access

Authors

  • Noh, Jung-woo, Dr. Chun & Cho Medical Clinic & Dialysis Center, Seoul, Korea (the Republic of)
  • Park, Hayne C., Hallym University Kidney Research Institute, Seoul, Korea (the Republic of)
  • Han, Chaehoon, kangnam secred heart hospital, Seoul, Korea (the Republic of)
Background

Maintaining patency of vascular access in hemodialysis patients is important because it is a life-saving vessel. We investigated the effect of aspirin resistance and mean platelet volume (MPV) on vascular access(VA) failure in hemodialysis (HD) patients.

Methods

We enrolled 163 maintenance HD patients. Aspirin resistance was defined as aspirin resistance unit (ARU) >550. VA failure was defined as thrombosis or a decrease of greater than 50% of normal vessel diameter which was angiographically documented reduction with ≥ 50 % luminal diameter accompanied by abnormal clinical findings.

Results

163 patients showed a mean age of 57.6 ±12.0 years and 79 were male (48.5 %). Mean dialysis duration was 50.1 ± 52.1 months. Aspirin resistance was observed in 17 out of 109 patients who measured the value. During a follow-up period of 34 months, 65 VA failures occurred out of all subjects while 41 events among the failures occurred in a patient group who measured aspirin resistance. There was no significant difference between the two groups according to aspirin resistance in the cumulative event rate of VA failures (57% vs. 38.2%, log-rank test, p=0.051). Mean MPV was 9.15 ± 0.05 fl. The 163 patients were grouped according to half-tile values of MPV (9.08 fl) at baseline and ones with higher MPV levels (n=82) had exhibited lower levels of platelet count (p=0.002), albumin (p=0.009). The Kaplan-Meier curve showed significant difference between two groups in cumulative events of VA failure (54.1% vs 35.3%, p=0.018). In multivariate analysis, MPV (HR 1.794; 95% CI1.066-3.020; p=0.028), platelet count (HR 1.003; 95% CI 1.001-1.006; p=0.01) and smoking (HR 1.894; 95% CI 1.019-3.519; p=0.043) were independent predictive factors of VA failure.

Conclusion

High MPV was associated with increased risk of VA failure. However, aspirin resistance showed a weak relationship with VA failure. MPV may be a potential marker for prediction of VA survival in HD patients.