Effects of aspirin resistance and mean platelet volume on vascular access failure in hemodialysis patients

• Published in: The Korean journal of internal medicine Vol. 34; no. 6; pp. 1304 - 1312
• Main Authors: Ajin Cho, Myung Jin Choi, Young-ki Lee, Han Chae Hoon, Ja-ryong Koo, Jong-woo Yoon, Jung-woo Noh
• Format: Journal Article
• Language: Korean
• Published: 대한내과학회 30.11.2019
• Subjects: Aspirin resistance; Mean platelet volume; Renal dialysis; Vascular ac-cess
• ISSN: 1226-3303; 2005-6648

Background/Aims: Maintaining the patency of vascular access (VA) in hemodialysis (HD) patients is important and can be life-saving. We investigated the effects of aspirin resistance and mean platelet volume (MPV) on VA failure in HD patients. Methods: We enrolled 163 patients on maintenance HD. VA failure was defined as thrombosis or a decrease of > 50% of the normal vessel diameter, as revealed by angiography. Results: Aspirin resistance was observed in 17 of 109 patients in whom this parameter was measured, and was not signi.cantly associated with VA failure (p = 0.051). The mean MPV was 9.15 ?0.05 fL. The 163 patients were grouped by the median MPV value (9.08 fL) at baseline; patients with higher MPVs (n = 82) had lower platelet counts (p = 0.002) and albumin levels (p = 0.009). During 34 months of follow-up, 65 VA failures (39.9%) occurred. The Kaplan-Meier curve revealed significant differences between the two groups in terms of cumulative VA failure (54.1% vs. 35.3%, p = 0.018). On multivariate analysis, the MPV (hazard ratio [HR], 1.794; 95% confidence interval [CI], 1.066 to 3.020; p = 0.028), platelet count (HR, 1.003; 95% CI, 1.001 to 1.006; p = 0.01), and smoking status (HR, 1.894; 95% CI, 1.019 to 3.519; p = 0.043) independently predicted VA failure. Conclusions: A high MPV was associated with an increased risk of VA failure, whereas aspirin resistance showed only a weak association. The MPV may predict VA survival in HD patients.