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Relationship of late arteriovenous fistula stenosis with soluble E-selectin and soluble EPCR in chronic hemodialysis patients with arteriovenous fistula
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Relationship of late arteriovenous fistula stenosis with soluble E-selectin and soluble EPCR in chronic hemodialysis patients with arteriovenous fistula
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Relationship of late arteriovenous fistula stenosis with soluble E-selectin and soluble EPCR in chronic hemodialysis patients with arteriovenous fistula
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Journal Article
Relationship of late arteriovenous fistula stenosis with soluble E-selectin and soluble EPCR in chronic hemodialysis patients with arteriovenous fistula
2015
Overview
Background/aims
Vascular access dysfunction caused by stenosis is a major complication for hemodialysis (HD) patients. However, physiopathology of late arteriovenous fistula (AVF) stenosis is still under investigation. The aim of the present study was to evaluate the association between plasma soluble EPCR (sEPCR) with serum soluble E-selectin (sE-selectin) concentration and late AVF stenosis in HD patients.
Methods
Plasma sEPCR and serum sE-selectin concentrations were measured in 94 HD patients. Using these data, we studied the association of sEPCR and sE-selectin with the presence and degree of AVF stenosis using ultrasonography and fistulogram.
Results
Fifty-one patients have AVF stenosis, and the others (
n
= 43) have patent AVF. The degree of AVF stenosis was correlated with serum sE-selectin levels (
r
= 0.351,
p
= 0.01), but not sEPCR (
r
= 0.075,
p
= 0.702). The median level of sE-selectin was statistically higher in the group of AVF stenosis than in the group of patent AVF [463.2 pg/ml (275.4–671.4) vs. 162.5 pg/ml (96.7–285.3),
p
= 0.001]. Increased sE-selectin levels [OR (OR) = 6.356,
p
= 0.015] and high levels of LDL (OR = 4.321,
p
= 0.044) were independent predictors of late AVF stenosis in the multivariate model.
Conclusions
sE-selectin and the LDL were the most important predictors of late AVF stenosis. In addition, sE-selectin correlated with the degree of AVF stenosis. We suggested that atherosclerosis might be contributing factor for development of late AVF stenosis.
Publisher
Springer Japan,Springer Nature B.V
Subject
/ Aged
/ Angiography, Digital Subtraction
/ Arteriovenous Fistula - diagnostic imaging
/ Arteriovenous Fistula - pathology
/ Endothelial Protein C Receptor
/ Female
/ Humans
/ Kidney Failure, Chronic - blood
/ Kidney Failure, Chronic - diagnostic imaging
/ Kidney Failure, Chronic - pathology
/ Male
/ Medicine
/ Receptors, Cell Surface - blood
/ Ultrasonography, Doppler, Color
/ Urology
