Kidney Week

Abstract: FR-PO710

Zinc Deficiency Is a Risk for Vascular Access Failure in Hemodialysis Patients

Session Information

• Dialysis: Vascular Access - I
  October 26, 2018 | Location: Exhibit Hall, San Diego Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Dialysis

• 704 Dialysis: Vascular Access

Authors

• Hasuike, Yukiko, Internal Medicine, Division of Kidney and Dialysis, Nishinomiya, Japan

Yukiko Hasuike,

• Kakita, Naoto, Mitsubishi Kobe Hospital, Kobe, Japan

Naoto Kakita,

• Nanami, Masayoshi, Internal Medicine, Division of Kidney and Dialysis, Nishinomiya, Japan

Masayoshi Nanami,

• Mizusaki, Kosuke, Internal Medicine, Division of Kidney and Dialysis, Nishinomiya, Japan

Kosuke Mizusaki,

• Fukao, Wataru, Internal Medicine, Division of Kidney and Dialysis, Nishinomiya, Japan

Wataru Fukao,

• Kida, Aritoshi, Internal Medicine, Division of Kidney and Dialysis, Nishinomiya, Japan

Aritoshi Kida,

• Yahiro, Mana, Internal Medicine, Division of Kidney and Dialysis, Nishinomiya, Japan

Mana Yahiro,

• Nagasawa, Yasuyuki, Internal Medicine, Division of Kidney and Dialysis, Nishinomiya, Japan

Yasuyuki Nagasawa,

• Kuragano, Takahiro, Internal Medicine, Division of Kidney and Dialysis, Nishinomiya, Japan

Takahiro Kuragano,

• Ishihara, Masaharu, Internal Medicine, Division of Kidney and Dialysis, Nishinomiya, Japan

Masaharu Ishihara,

Background

Vascular access (VA) is essential for the hemodialysis (HD) patients. Percutaneous transluminal angioplasty (PTA) is an effective therapy against VA failure, however, re-failure of VA is often occurred even after PTA. Zinc plays a role in endothelial cell function, and Zinc deficiency can effect vascular dysfunction. To investigate the association of Zinc deficiency with VA failure, serum Zinc and the patency of VA following PTA were examined.

Methods

Blood samples were taken from 337 HD patients at PTA against VA failure. Serum Zinc, factors related to mineral-bone metabolism (Ca, iP, PTH-intact [iPTH], ALP), 8-hydroxy-2’-deoxyguanosine (8OHdG) as a maker of oxidative stress, inflammation (CRP, interleukin-6, tumor necrosis factor-α), and uremia (BMI, albumin, urea nitrogen, Hb) were measured. The end point of study was VA failure (re-vascularization or re-operation) during the observational period after PTA. Cox proportional hazards models for the end point was used.

Results

During follow-up period (median 367 days), re-vascularization was performed in 67 participants and re-operation in 69. The median of serum Zinc was 63 pg/ml (IQR 56 to 74), and 130 (38.6%) participants had Zn deficiency (<60 pg/ml). The participants with VA failure had lower Zn (p=0.03), higher iPTH, and a tendency to high 8OHdG compared with the participants without VA failure. There was no difference in the other factors. The Kaplan-Meier analysis showed that the participants with Zn deficiency was associated with higher incidence of VA failure (Figure 1). Cox regression analysis also revealed that Zn deficiency (adjusted hazard ratio 1.51, 95% CI 1.06 to 2.13, p=0.022) was a risk for VA failure.

Conclusion

Zinc deficiency was an independent risk for VA failure. Zinc might be associated with the maintenance of VA patency in HD patients.