S T Shafi1, M Gupta. 1. Division of Nephrology, Department of Internal Medicine, University of Iowa Hospitals and Clinics, Iowa City, IA, USA. salmanshafi@email.com
Abstract
INTRODUCTION: Anticardiolipin antibody is associated with increased risk of vascular access thrombosis (VAT) in hemodialysis (HD) patients. Systemic lupus erythematous (SLE) patients have a high prevalence of anticardiolipin antibodies, but it is not clear whether these patients are at high risk of developing vascular access thrombosis. METHODS: Thirty six SLE patients on HD, who had either an arterio-venous (AV) graft or AV fistula as vascular access, and were not on anticoagulation treatment, were retrospectively identified at Henry Ford Hospital. A similar number of patients without SLE, matched for age, sex, race and type of vascular access were selected as a control population. Vascular access thrombosis rate at one year was compared between two groups. RESULTS: Mean age at dialysis was 36+/-10 years in 36 SLE patients (28 females, 8 males) and was 38+/-6.4 years in 36 non-SLE patients (29 females, 7 males). Of all patients, 29/36 (80.5%) SLE and 27/36 (75%) non-SLE patients had AV grafts, whereas the rest had AV fistulas as vascular access (19.5% SLE and 25% non-SLE patients). Out of 36 SLE patients, 24 (66.6%) patients developed VAT at one year as compared to 14 (38.9%) patients in non-SLE group (p<0.05). The odds ratio of VAT in SLE patients was 3.1 (95% CI 1.2-8.2). CONCLUSION: SLE patients on hemodialysis are more likely to develop vascular access thrombosis as compared to non-SLE patients.
INTRODUCTION: Anticardiolipin antibody is associated with increased risk of vascular access thrombosis (VAT) in hemodialysis (HD) patients. Systemic lupus erythematous (SLE) patients have a high prevalence of anticardiolipin antibodies, but it is not clear whether these patients are at high risk of developing vascular access thrombosis. METHODS: Thirty six SLEpatients on HD, who had either an arterio-venous (AV) graft or AV fistula as vascular access, and were not on anticoagulation treatment, were retrospectively identified at Henry Ford Hospital. A similar number of patients without SLE, matched for age, sex, race and type of vascular access were selected as a control population. Vascular access thrombosis rate at one year was compared between two groups. RESULTS: Mean age at dialysis was 36+/-10 years in 36 SLEpatients (28 females, 8 males) and was 38+/-6.4 years in 36 non-SLEpatients (29 females, 7 males). Of all patients, 29/36 (80.5%) SLE and 27/36 (75%) non-SLEpatients had AV grafts, whereas the rest had AV fistulas as vascular access (19.5% SLE and 25% non-SLEpatients). Out of 36 SLEpatients, 24 (66.6%) patients developed VAT at one year as compared to 14 (38.9%) patients in non-SLE group (p<0.05). The odds ratio of VAT in SLEpatients was 3.1 (95% CI 1.2-8.2). CONCLUSION:SLEpatients on hemodialysis are more likely to develop vascular access thrombosis as compared to non-SLEpatients.
Authors: Sangeeta D Sule; Jeffrey J Fadrowski; Barbara A Fivush; Alicia M Neu; Susan L Furth Journal: Pediatr Nephrol Date: 2009-06-13 Impact factor: 3.714