Xianglei Kong1, Jing Du2,3, Hong Su2, Qinlan Chen2, Lijun Tang1, Lei Zhang1, Zunsong Wang1, Liming Liang4, Dongmei Xu5,6,7,8. 1. Department of Nephrology, Shandong Provincial Qianfoshan Hospital, Shandong University, No. 16766, Jingshi Road, Jinan, 250014, People's Republic of China. 2. Qilu Medical College, Shandong University, No. 44, Wenhua West Road, Jinan, China. 3. Center of Blood Purification, Weifang People's Hospital, No. 151, Guangwen Street, Kuiwen District, Weifang, China. 4. Department of Nephrology, Shandong Provincial Qianfoshan Hospital, Shandong University, No. 16766, Jingshi Road, Jinan, 250014, People's Republic of China. 852402865@qq.com. 5. Department of Nephrology, Shandong Provincial Qianfoshan Hospital, Shandong University, No. 16766, Jingshi Road, Jinan, 250014, People's Republic of China. qianyixdmgmail@163.com. 6. Shandong Provincial Key Laboratory for Rheumatic Disease and Translational Medicine, No. 16766, Jingshi Road, Jinan, 250014, People's Republic of China. qianyixdmgmail@163.com. 7. Department of Nephrology, The First Affiliated Hospital of Shandong First Medical University, No. 16766, Jingshi Road, Jinan, 250014, People's Republic of China. qianyixdmgmail@163.com. 8. Nephrology Research Institute of Shandong Province, No. 16766, Jingshi Road, Jinan, 250014, People's Republic of China. qianyixdmgmail@163.com.
Abstract
BACKGROUND: The relationship between the endothelial glycocalyx constituents and the early failure of autologous arteriovenous fistulas (AVFs) in ESRD patients is still unknown. METHODS: In this prospective cohort study, 181 ESRD patients (the mean age was 53.3 ± 11.8 years, 66.3% of them were males) received forearm AVFs surgery were consecutively enrolled with a median follow-up time of 10 months. The early AVF failure was defined as a fistula that never developed adequately for dialysis use or that failed within the first 3 months of use. The serum levels of glycocalyx constituents including glypicans-1 (GPC-1), syndecans-1 (SDC-1), and hyaluronan (HA), and the indicator of endothelial activation reflected by E-selectin (ES) were determined by ELISAs. RESULTS: The primary patencies of AVFs were 98.3%, 96.7%, 91.7%, and 89.5% at 3, 6, 12, and 18 months, respectively. The ROC curve was plotted and demonstrated that HA, not GPC-1, SDC-1 or ES, can diagnose the AVF failure, with the cut-off value of 6.37 ng/ml, the sensitivity of 87.5%, the specificity of 46.9%, and the Youden index of 0.34, respectively. The Kaplan-Meier survival analysis demonstrated that patients with HA < 6.37 ng/mL had better patency of AVFs than patients with HA ≥ 6.37 ng/mL (log-rank test, p = 0.008). In the Cox proportional hazards analysis, after adjusting for confounders, HA (≥ 6.37 ng/mL vs. < 6.37 ng/mL) was associated with the early AVFs failure, with the OR of 5.88 (1.21-28.60). CONCLUSIONS: This study demonstrated that HA can predict the early failure of forearm AVFs, when its serum level is more than 6.37 ng/mL.
BACKGROUND: The relationship between the endothelial glycocalyx constituents and the early failure of autologous arteriovenous fistulas (AVFs) in ESRDpatients is still unknown. METHODS: In this prospective cohort study, 181 ESRDpatients (the mean age was 53.3 ± 11.8 years, 66.3% of them were males) received forearm AVFs surgery were consecutively enrolled with a median follow-up time of 10 months. The early AVF failure was defined as a fistula that never developed adequately for dialysis use or that failed within the first 3 months of use. The serum levels of glycocalyx constituents including glypicans-1 (GPC-1), syndecans-1 (SDC-1), and hyaluronan (HA), and the indicator of endothelial activation reflected by E-selectin (ES) were determined by ELISAs. RESULTS: The primary patencies of AVFs were 98.3%, 96.7%, 91.7%, and 89.5% at 3, 6, 12, and 18 months, respectively. The ROC curve was plotted and demonstrated that HA, not GPC-1, SDC-1 or ES, can diagnose the AVF failure, with the cut-off value of 6.37 ng/ml, the sensitivity of 87.5%, the specificity of 46.9%, and the Youden index of 0.34, respectively. The Kaplan-Meier survival analysis demonstrated that patients with HA < 6.37 ng/mL had better patency of AVFs than patients with HA ≥ 6.37 ng/mL (log-rank test, p = 0.008). In the Cox proportional hazards analysis, after adjusting for confounders, HA (≥ 6.37 ng/mL vs. < 6.37 ng/mL) was associated with the early AVFs failure, with the OR of 5.88 (1.21-28.60). CONCLUSIONS: This study demonstrated that HA can predict the early failure of forearm AVFs, when its serum level is more than 6.37 ng/mL.
Authors: Aleksandar Jankovic; Tatjana Damjanovic; Zivka Djuric; Jelena Marinkovic; Georg Schlieper; Jelena Tosic-Dragovic; Petar Djuric; Jovan Popovic; Juergen Floege; Nada Dimkovic Journal: Nephron Date: 2015-03-21 Impact factor: 2.847
Authors: Max Nieuwdorp; Timon W van Haeften; Mirella C L G Gouverneur; Hans L Mooij; Miriam H P van Lieshout; Marcel Levi; Joost C M Meijers; Frits Holleman; Joost B L Hoekstra; Hans Vink; John J P Kastelein; Erik S G Stroes Journal: Diabetes Date: 2006-02 Impact factor: 9.461
Authors: Markus Rehm; Dirk Bruegger; Frank Christ; Peter Conzen; Manfred Thiel; Matthias Jacob; Daniel Chappell; Mechthild Stoeckelhuber; Ulrich Welsch; Bruno Reichart; Klaus Peter; Bernhard F Becker Journal: Circulation Date: 2007-10-08 Impact factor: 29.690
Authors: Jan-Sören Padberg; Anne Wiesinger; Giovana Seno di Marco; Stefan Reuter; Alexander Grabner; Dominik Kentrup; Alexander Lukasz; Hans Oberleithner; Hermann Pavenstädt; Marcus Brand; Philipp Kümpers Journal: Atherosclerosis Date: 2014-03-29 Impact factor: 5.162
Authors: Carmen A Vlahu; Bregtje A Lemkes; Dirk G Struijk; Marion G Koopman; Raymond T Krediet; Hans Vink Journal: J Am Soc Nephrol Date: 2012-10-18 Impact factor: 10.121