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BioMed Research International
Volume 2017, Article ID 6728437, 9 pages
https://doi.org/10.1155/2017/6728437
Research Article

Aortic Arch Calcification as a Predictor of Repeated Arteriovenous Fistula Failure within 1-Year in Hemodialysis Patients

1Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan
2Division of Nephrology, Department of Internal Medicine, Yuan’s General Hospital, Kaohsiung 802, Taiwan
3Division of Gastroenterology, Department of Internal Medicine, Yuan’s General Hospital, Kaohsiung 802, Taiwan
4Division of Hepatobiliary, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan

Correspondence should be addressed to Po-Lin Kuo; wt.ude.umk.cc@nilopouk and Wan-Long Chuang; moc.liamg@peh.hcolaw

Received 13 January 2017; Revised 14 April 2017; Accepted 20 April 2017; Published 31 May 2017

Academic Editor: Fumio Imazeki

Copyright © 2017 Yit-Sheung Yap et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objectives. The aim of the study was to identify the factors associated with repeated arteriovenous fistula (AVF) failure within 1-year, especially the impact of aortic arch calcification (AAC) on patency of AVF. Materials and Methods. We retrospectively assessed chest radiography in hemodialysis patients who had undergone initial AVF. The extent of AAC was categorized into four grades (0–3). The association between AAC grade, other clinical variables, and repeated failure of AVF was then analyzed by binary logistic regression analysis. Results. This study included 284 patients (158 males, mean age years). Patients with higher AAC grade were older, had more frequently diabetes mellitus and cardiovascular disease, had lower diastolic blood pressure, and had higher corrected calcium and lower intact parathyroid hormone levels. In multivariate analysis, the presence of higher AAC grade (odds ratio (95% confidence interval): 2.98 (1.43–6.23); ), lower mean corrected calcium (), and mean serum albumin level () were associated with repeated failure of AVF. Conclusions. The presence of higher AAC grade, lower mean corrected calcium and mean serum albumin level were independently associated with repeated AVF failure within 1 year in hemodialysis patients.