+ Site Statistics
References:
54,258,434
Abstracts:
29,560,870
PMIDs:
28,072,757
+ Search Articles
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ PDF Full Text
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Translate
+ Recently Requested

No association between hyperhomocysteinemia and vascular access thrombosis in chronic hemodialysis



No association between hyperhomocysteinemia and vascular access thrombosis in chronic hemodialysis



Journal of Vascular Access 4(1): 14-20



PURPOSE. Hyperhomocysteinemia, recognized as a risk factor for cardiovascular diseases, has also been related with controversy to vascular access thrombosis in hemodialysis. Our objective was to determine if such an association could be found in our hemodialysis population. METHODS. The survey was conducted in a cohort of 165 chronic hemodialysis patients. Their vascular access history was considered from hemodialysis initiation until November 1999, including the number of vascular accesses created (either native or synthetic fistulae), focussing on vascular access thrombotic events, and excluding primary vascular access dysfunction. Diabetes, hemoglobin, erythropoietin dose, anticoagulation, and methyltetrahydrofolate reductase (MTHFR) status were considered. Serum total homocysteine (tHcy) measures were sampled for all patients in June 1998 and repeated yearly. Patients had not been supplemented routinely with hydrosoluble vitamins until June 1998, after which all received DiaVite (R&D Laboratories, CA, USA) daily. RESULTS. Median survival of native fistulae was significantly longer (81 months, 95%CI 35-127) than for synthetic fistulae (31 months, 95%CI 27-51). Median vascular access survival was reduced for diabetics vs non diabetics (28 vs 57 months) (p<0.05), whereas sex, age and smoking had no impact. No correlation was found between tHcy concentration and the number of vascular access thrombotic events; homozygotes for MTHFR had higher tHcy but no more vascular access thrombotic events. The 38 patients with a mean vascular access survival of less than 12 months (63 months) were compared to the 127 patients with a mean vascular access survival of >= 12 months (3925 months) (p<0.05): no difference in their respective tHcy concentrations before and after DiaVite introduction was found (3113 and 208 vs 3417 and 226 mol/L), but the first group presented more numerous synthetic fistulae (p<0.0001), lower hemoglobin levels, and higher erythropoietin doses. CONCLUSIONS. No significant association between hyperhomocysteinemia and vascular access thrombosis could be found in our population. DiaVite introduction allowed a significant reduction in tHcy, but had no impact on vascular access survival, except for a slight but not significant reduction in the prevalence of vascular access thrombotic events during the year on DiaVite. Potential benefits of approaches to reduce tHcy for vascular access time-life prolongation remain to be demonstrated.

(PDF emailed within 1 workday: $29.90)

Accession: 054629320

Download citation: RISBibTeXText

PMID: 24122328


Related references

Hyperhomocysteinemia and vascular access thrombosis in chronic hemodialysis Is there an association?. Journal of the American Society of Nephrology 11(Program and Abstract Issue): 282A, 2000

Hyperhomocysteinemia and vascular access thrombosis in hemodialysis patients: a retrospective study. Vascular Health and Risk Management 9: 361-364, 2013

Hyperhomocysteinemia, anticardiolipin antibody status, and risk for vascular access thrombosis in hemodialysis patients. Kidney International 55(1): 315-320, 1999

Role of the hyperhomocysteinemia and coagulation-fibrinolytic system activity status in vascular access thrombosis in hemodialysis patients. Nephrology Dialysis Transplantation 15(9): A190, 2000

IgM-anticardiolipin antibody and vascular access thrombosis in chronic hemodialysis patients. Renal Failure 27(1): 25-30, 2005

Association Between Thrombophilic Gene Mutations and the Risk of Vascular Access Thrombosis in Hemodialysis Patients. Therapeutic Apheresis and Dialysis 20(2): 107-111, 2017

Role of thrombophilia in vascular access thrombosis among chronic hemodialysis patients in Tunisia. Therapeutic Apheresis and Dialysis 15(1): 40-43, 2011

Atrial fibrillation linked to vascular access thrombosis in chronic hemodialysis patients. Journal of Atherosclerosis and Thrombosis 18(6): 448-453, 2011

Vascular access thrombosis is not related to presence of antiphospholipid antibodies in patients on chronic hemodialysis. Nephron 92(4): 957-958, 2002

Hyperhomocysteinaemia and vascular access thrombosis among chronic hemodialysis patients in Taiwan: a retrospective study. International Journal of Clinical Practice 60(12): 1596-1599, 2006

Use of enoxaparin to diminish the incidence of vascular access stenosis/thrombosis in chronic hemodialysis patients. International Urology and Nephrology 43(2): 499-505, 2011

The prevalence of antibodies to the platelet factor 4 -heparin complex and association with access thrombosis in patients on chronic hemodialysis. Thrombosis Research 120(2): 215-220, 2006

Recombinant streptokinase treatment of thrombosis of the permanent vascular access in chronic renal insufficiency patients treated with periodic hemodialysis. Biotecnologia Aplicada 12(3): 195-196, 1995

Thombotic events in vascular access of hemodialysis patients and the correlation with hyperhomocysteinemia, lipids and oxidative stress. Nephrology Dialysis Transplantation 17(Abstracts Supplement 1): 284, 2002

Hyperhomocysteinemia and levels of lipoprotein are inversely related to failure of vascular access in patients on maintenance hemodialysis. Journal of the American Society of Nephrology 9(PROGRAM AND ABSTR ISSUE): 252A-253A, Sept, 1997