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Abstract: FR-PO486

Metabolomic Analysis of Plasma Samples Collected Before Arteriovenous Fistula Creation Reveals Metabolome Clusters that Associate with Maturation Outcomes

Session Information

  • Dialysis: Vascular Access
    November 03, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
    Abstract Time: 10:00 AM - 12:00 PM

Category: Dialysis

  • 803 Dialysis: Vascular Access

Authors

  • Wang, Xin, Renal Research Institute, New York, New York, United States
  • Zaidi, Syed Shaukat Abbas, Manchester Royal Infirmary, Manchester University NHS Foundation Trust, Manchester, United Kingdom
  • Chan, Cindy, Fresenius Medical Care Asia Pacific Ltd, Hong Kong, Hong Kong
  • Cheung, Yan Yi, Global Medical Office, Fresenius Medical Care, Singapore, Singapore
  • Grobe, Nadja, Renal Research Institute, New York, New York, United States
  • Kotanko, Peter, Renal Research Institute, New York, New York, United States
  • Mitra, Sandip, Manchester Royal Infirmary, Manchester University NHS Foundation Trust, Manchester, United Kingdom
  • Nikam, Milind, Global Medical Office, Fresenius Medical Care, Singapore, Singapore
Background

The Manchester Vascular Access study was a prospective observational study intended to investigate the natural history and maturation of arteriovenous fistulas (AVF). We aimed to identify biomarkers that predict maturation success already before AVF creation.

Methods

Plasma samples were obtained before AVF creation. Unassisted maturation was defined either by successful hemodialysis or a combination of ultrasound features (vein size > 4 mm with fistula flow ≥ 500 ml/min) and clinical assessment. Untargeted metabolomic analysis employed liquid chromatography-mass spectrometry. Hierarchical clustering and principal component analyses were performed to cluster patients using 819 metabolite features. We used Chi-square test to explore differences in demographics, comorbidities, and AVF maturation between clusters.

Results

We studied 44 patients. Metabolomic analysis revealed 2 clusters (Cluster 1: 21 patients, Cluster 2: 23 patients) with diverse levels of plasma metabolites (Fig. 1). There was a significant statistical difference in unassisted maturation rates between the two clusters (Cluster 1: 85.7% vs. Cluster 2: 43.5%; p=0.0095). No significant differences between the clusters were found with respect to variables commonly associated with maturation (age, sex, diabetes, and cardiovascular disease).

Conclusion

In this cohort, we observed 2 clusters of metabolomic signatures associated with successful and unsuccessful AVF maturation, respectively. If corroborated in a larger cohort, metabolomic analysis could help identify biomarkers that predict AVF maturation success or failure already prior to AVF creation, thus allowing individualisation of vascular access planning. Future targeted metabolomic analysis may also shed light on biological pathways related to AVF maturation.

Funding

  • Commercial Support – Fresenius Medical Care