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Kidney Week

Abstract: SA-PO1113

Prognosis of Vascular Access in Hemodialysis Patients with Autosomal Dominant Polycystic Kidney Disease

Session Information

  • Vascular Access - II
    November 09, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
    Abstract Time: 10:00 AM - 12:00 PM

Category: Dialysis

  • 704 Dialysis: Vascular Access

Author

  • Lin, Chih-Ching, Taipei Veterans General Hospital, Taipei City, Taiwan
Background

Vascular diseases, including aneurysms of intracerebral arteries and abdominal aorta are commonly observed in patients with autosomal dominant polycystic kidney disease (ADPKD). We aimed to investigate the difference in the risk of malfunction of arteriovenous fistula or graft (AVF/AVG) between hemodialysis (HD) patients with and without ADPKD.

Methods

We enrolled 354 HD patients with ADPKD and 28264 HD patients without ADPKD in this study. Only 1062 propensity score-matched HD patients without ADPKD were included for analysis. The outcomes include the rate of AVF/AVG malfunction which is defined as the need for the first interventional procedure of either angioplasty, thrombectomy or creation of another AVF/AVG for all HD patients within 3 months, 1, 5 and 10 years respectively.

Results

The malfunction rate (per 100 person-years) of AVF/AVG for ADPKD and non-ADPKD was (1) 20.1 and 30.38 [HR=0.68, P=0.144] within 90 days, (2) 34.85 and 30.38 [HR=1.08, P=0.517] in first year, (3) 23.56 and 20.46 [HR=1.12, P=0.154] within 5 years, (4) 17.82 and 12.59 [HR=1.36, P=0.004] between 1st and 10th years, and (5) 22.6 and 17.52 [HR=1.21, P=0.015] at all period respectively.

Conclusion

In comparison with non-ADPKD patients, ADPKD patients had a trend of lower risk of AVF/AVG malfunction in the first 90 days but a significant higher risk after 1 year of AVF/AVG creation.

Kaplan-Meier figure estimates show any new AVF cration or PTA representing AVF failure There is an overlapping of curves of the ADPKD and non-ADPKD group around 1-year follow-up period.

Funding

  • Government Support - Non-U.S.