| Association of low serum fetuin A levels with poor arteriovenous access patency in patients undergoing maintenance hemodialysis. | |
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MedLine Citation:
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PMID: 20801568 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Fetuin A, a predictor of mortality in dialysis patients, is associated with vascular calcification and atherosclerosis in hemodialysis (HD) patients. Whether it predicts arteriovenous (AV) access patency is unknown. This study aimed to investigate the association between fetuin A and AV access patency in HD patients. STUDY DESIGN: Prospective observational study. SETTING & PARTICIPANTS: 238 prevalent HD patients (127 women and 111 men; mean age, 60 ± 12 years) were followed up for AV access patency for 32 months. PREDICTORS: Tertiles of baseline circulating fetuin A levels, corresponding to 0.15-0.25, 0.26-0.32, and 0.33-0.51 g/L. OUTCOME: The major outcome was loss of unassisted AV access patency, defined as AV access thrombosis or need for intervention. MEASUREMENTS: Fetuin A and other markers of inflammation. RESULTS: 100 patients had loss of AV access patency (42%) on follow-up. Patients in the lowest fetuin A tertile had the worst AV access patency (log-rank test, χ(2) = 8.68; P = 0.01). Using Cox proportional hazards regression with patients in the lowest fetuin A tertile as reference, patients in the intermediate tertile had an HR of 0.49 (95% CI, 0.29-0.82), whereas those in the highest fetuin A tertile had an HR of 0.43 (95% CI, 0.25-0.75) for loss of AV access patency. Similarly, considering patients using AV fistulas or grafts separately, patients in the highest fetuin A tertile had less risk of losing AV access patency than patients in the other tertiles (HR, 0.40 [95% CI, 0.19-0.84] for patients with AV fistulas and HR, 0.25 [95% CI, 0.10-0.65] for patients with AV grafts). LIMITATIONS: Focus on the patency of prevalent rather than new AV access in maintenance hemodialysis patients. CONCLUSIONS: Fetuin A deficiency is associated with a higher risk of loss of AV access patency in either native AV fistulas or AV grafts in HD patients. |
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Authors:
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Hung-Yuan Chen; Yen-Ling Chiu; Yi-Fang Chuang; Shih-Ping Hsu; Mei-Fen Pai; Chun-Fu Lai; Ju-Yeh Yang; Yu-Sen Peng; Tun-Jun Tsai; Kwan-Dun Wu |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: American journal of kidney diseases : the official journal of the National Kidney Foundation Volume: 56 ISSN: 1523-6838 ISO Abbreviation: Am. J. Kidney Dis. Publication Date: 2010 Oct |
Date Detail:
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Created Date: 2010-09-20 Completed Date: 2010-10-13 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8110075 Medline TA: Am J Kidney Dis Country: United States |
Other Details:
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Languages: eng Pagination: 720-7 Citation Subset: IM |
Copyright Information:
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Copyright © 2010 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved. |
Affiliation:
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Division of Nephrology, Department of Internal Medicine, Far Eastern Memorial Hospital, Taipei, Taiwan. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Arteriovenous Shunt, Surgical / adverse effects* Biological Markers / blood Catheters, Indwelling / adverse effects* Confidence Intervals Female Follow-Up Studies Humans Kaplan-Meiers Estimate Kidney Failure, Chronic / therapy* Male Middle Aged Proportional Hazards Models Prospective Studies Renal Dialysis / adverse effects, methods Risk Assessment Sensitivity and Specificity Vascular Patency* alpha-Fetoproteins / analysis* |
| Chemical | |
Reg. No./Substance:
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0/Biological Markers; 0/alpha-Fetoproteins |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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