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Abstract: FR-PO496

Differences in Vascular Access Can Influence the Level of Thrombo-Inflammation and Oxidative Stress in Patients with Hemodialysis

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

  • Siddiqui, Fakiha, Loyola University Medical Center, Maywood, Illinois, United States
  • Nikolovski, Srdjan, Loyola University Medical Center, Maywood, Illinois, United States
  • Kantarcioglu, Bulent, Loyola University Medical Center, Maywood, Illinois, United States
  • Hoppensteadt, Debra, Loyola University Medical Center, Maywood, Illinois, United States
  • Iqbal, Omer M., Loyola University Medical Center, Maywood, Illinois, United States
  • Krupa, Emily G., Loyola University Medical Center, Maywood, Illinois, United States
  • Fareed, Jawed, Loyola University Medical Center, Maywood, Illinois, United States
  • Bansal, Vinod K., Loyola University Medical Center Department of Nephrology, Maywood, Illinois, United States
Background

Patients undergoing hemodialysis require vascular access which includes arteriovenous (AV) fistula, AV graft, and tunneled catheter. At these sites changes in the vessel wall result in a positive feedback loop that propagates inflammation and cell proliferation which can progress to stenosis and thrombosis. This study was designed to compare the levels of biomarker of thrombo-inflammation and oxidative stress in patients with ESRD requiring different vascular access sites.

Methods

A prospective cohort of 95 patients undergoing hemodialysis at Loyola University Chicago were compared to 50 normal healthy individuals. The ESRD patients were stratified according to the vascular access sites. All plasma samples were analyzed for D-Dimer, PAI-1 antigen, vWF, CRP, annexin V, MPO, nitotyrosine, eNOs, IL4, IL6, IL10, VEGF, and EGF by using Sandwich ELISA methods and Randox Biochip Array.

Results

The ESRD patient cohort included 48 male and 47 female, with the median age 66-years, weight 77-kg and BMI 27.2-kg/m2. The levels of thrombo-inflammation and oxidative stress marker were significantly (p <0.05) higher in ESRD patients while MPO, IL4, and IL10 were significantly (p <0.05) lower in ESRD patients compared to normal controls. The biomarker profiles demonstrated that various markers of thrombo-inflammation and oxidative stress were significantly elevated in patients with various vascular access types (table 1).

Conclusion

These studies suggest that ESRD patients with the AV fistula are at high risk of fibrinolytic deficit, inflammation, and oxidative stress they are at low risk of thrombosis. Patients with AV graft and tunneled catheter are at high risk of inflammation, oxidative stress, and thrombosis.