Thrombophilic risk factors and ABO blood group profile for arteriovenous access failure in end stage kidney disease patients: a single-center experience

• Published in: Renal failure Vol. 44; no. 1; pp. 34 - 42
• Main Authors: Anapalli, Sunnesh Reddy, N., Harini Devi, Sarma, Pvgk, Srikanth, Lokanathan, V., Siva Kumar
• Format: Journal Article
• Language: English
• Published: England Taylor & Francis 01.12.2022; Taylor & Francis Ltd; Taylor & Francis Group
• Subjects: ABO Blood-Group System; ABO system; acquired thrombophilic factors; Adult; Arteriovenous Fistula - etiology; arteriovenous fistula failure; Arteriovenous Shunt, Surgical - adverse effects; Blood groups; Cardiolipin; Clinical Study; Coagulation factors; Cross-Sectional Studies; End-stage kidney disease; End-stage renal disease; Factor V; Factor V - analysis; Failure; Female; Fibrinogen; Fistula; Fistulae; Hemodialysis; hemodialysis; hereditary thrombophilic factors; Homocysteine; Humans; Immunoglobulin G; Immunoglobulin M; Kidney diseases; Kidney Failure, Chronic - blood; Kidney Failure, Chronic - complications; Kidney Failure, Chronic - therapy; Male; Methylenetetrahydrofolate reductase; Middle Aged; Prothrombin; Renal Dialysis - adverse effects; Renal failure; Risk Factors; Statistical analysis; Tetrahydrofolic acid; Thrombophilia; Thrombophilia - etiology; Thrombophilia - genetics; Thrombosis; Thrombosis - etiology; End-stage kidney disease; acquired thrombophilic factors; hemodialysis; hereditary thrombophilic factors; arteriovenous fistula failure
• ISSN: 0886-022X; 1525-6049
• DOI: 10.1080/0886022X.2021.2011746

Thrombosis of fistula occurs most frequently in end-stage kidney disease (ESKD) patients receiving hemodialysis. However, the role of thrombophilia in arteriovenous fistula (AVF) failure has not been well established. Hence, this study was aimed at assessing the roles of hereditary and acquired thrombophilic factors in association with AVF failure among patients with ESKD undergoing hemodialysis. A cross-sectional study was conducted on 100 ESKD patients, of whom 50 patients with well-functioning AVFs with no fistula failures earlier were enrolled as Group 1, and 50 patients who have had AVF failure were enrolled as Group 2. The hereditary factors as factor V Leiden, factor XIII, prothrombin, and methylene tetrahydrofolate reductase and the acquired factors as lipoprotein (a), fibrinogen, homocysteine, and anticardiolipin antibodies IgG and IgM were studied. Among the hereditary factors, no statistically significant difference was observed in relation to factor V Leiden and Prothrombin (p > 0.05). However, for factor XIII and methylene tetrahydrofolate reductase, a statistically significant difference was observed between patients with well-functioning AVFs and patients who have had AVF failure (p < 0.05). We found a statistically significant increase in all the acquired factors in patients who have had AVF failure in comparison with patients with well-functioning AVFs (p < 0.001). Association between ABO blood groups and thrombophilic factors showed significant association between factor V Leiden, anticardiolipin antibody IgG and IgM and ABO blood groups (p < 0.05), whereas none of the other thrombophilic factors showed significant association (p > 0.05). Thus, our study suggests significant role of acquired factors in causing AVF failure.