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Abstract: PO1043

Long-Term Prognosis of Vascular Access in Hemodialysis Patients with Systemic Lupus Erythematosus

Session Information

Category: Dialysis

  • 703 Dialysis: Vascular Access

Author

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

Patients with systemic lupus erythematosus (SLE) have a higher risk of vascular complications.

Methods

This retrospective cohort study is aimed to analyze the differences in the risk of arteriovenous fistula or graft (AVF/AVG) dysfunction in hemodialysis (HD) patients with and without SLE from Taiwan Nationwide Health Insurance Database over a 10-year period. AVF/AVG dysfunction is defined as occurrence of the first episode of intervention after vascular access creation.This retrospective cohort study is aimed to analyze the differences in the risk of arteriovenous fistula or graft (AVF/AVG) dysfunction in hemodialysis (HD) patients with and without SLE from Taiwan Nationwide Health Insurance Database over a 10-year period. AVF/AVG dysfunction is defined as occurrence of the first episode of intervention after vascular access creation.

Results

Totally, 1366 HD patients with SLE had higher incidence rates of AVF/AVG dysfunction than 4098 non-SLE HD patients in the following 4 periods, (1) after 1 year (incidence rates were 15.21% and 13.01% respectively; subdistribution hazard ratio (SHR) = 1.16; P = 0.007), (2) 1st-to-10th-year period (15.36% and 13.25%; SHR = 1.16; P = 0.007), (3) 5th-to-10th-year period (11.91% and 8.1%; SHR = 1.42; P = 0.003), and (4) overall period (23.53% and 21.66%; SHR = 1.09; P = 0.027). There were significantly higher incidence rates of AVF/AVG dysfunction in SLE patients during the long-term follow-up period.

Conclusion

In conclusion, regular surveillance of vascular access function by clinical examination after 1 year, especially during 5 to 10 years, is needed to improve vascular access patency and dialysis adequacy in SLE patients undergoing maintenance hemodialysis.