Pentosidine in chronic hemodialysis patients: relation with arteriovenous fistula morphology and function
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It has been suggested that advanced glycation end products (AGEs) are involved in atherogenesis, vascular calcification and remodeling, including neointimal hyperplasia, in renal and non-renal patients. Their relevance for arteriovenous fistula (AVF) function has been poorly studied to date, with only one clinical study addressing the issue of thrombosis of vascular access in relation to AGEs in dialysis patients. We aimed to evaluate the relationship between serum pentosidine and AVF morphology and function.
Eighty-eighth hemodialysis patients with patent native AVF were included. Ultrasound examination of AVF evaluated blood flow in the brachial artery, resistivity index (RI), the diameter of the vessels and the presence of stenosis. AVF and cardiovascular history were recorded, routine clinical and laboratory evaluation was performed and serum pentosidine was assessed.
Forty-eight patients (54.54%) had AVF stenosis. Pentosidine correlated in univariate analysis with cholesterol (r = 0.270, p = 0.01), triglycerides (r = 0.309, p = 0.003), calcium (r = 0.040, p < 0.001) and inversely to dialysis vintage (r = − 0.453, p < 0.001), access vintage (r = − 0.432, p = 0.001), phosphate (r = − 0.211, p = 0.04), parathyroid hormone (r = − 0.211, p = 0.04), urea (r = − 0.230, p = 0.03), residual diameter of AVF (r = − 0.023, p = 0.03). In multivariate regression calcium (p = 0.006), access vintage (p = 0.03), and residual diameter of AVF vein (p = 0.02) remain significantly linked to pentosidine. Patients with pentosidine above median had higher cholesterol (179.91 vs. 160.97, p = 0.04), triglycerides (187.18 vs. 129.31, p = 0.002) and higher prevalence of hypertension (93.70% vs. 84.10%, p = 0.02).
Our study suggests that pentosidine could be associated to vascular access morphology and function in dialysis patients.
KeywordsArteriovenous fistula Hemodialysis Advanced glycation end product Stenosis Pentosidine
Compliance with ethical standards
Conflict of interest
Maria Ticala declares that she has no conflict of interest. Dacian Tirinescu declares that he has no conflict of interest. Crina Claudia Rusu declares that she has no conflict of interest. Diana Moldovan declares that she has no conflict of interest. Alina Ramona Potra declares that she has no conflict of interest. Anca Laura Coman declares that she has no conflict of interest. Cosmina Ioana Bondor declares that she has no conflict of interest. Livia Budisan declares that she has no conflict of interest. Ina Maria Kacso declares that she has no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments.
Informed consent was obtained from all individual participants included in the study.
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