MO778ASSOCIATION OF ADVANCED GLYCATION END PRODUCTS (AGE) AND INDOXYL SULPHATE  WITH ARTERIO-VENOUS FISTULA NON-MATURATION. (29th May 2021)

• Record Type: Journal Article
• Authors: Singh, Mansi; Mahapatra, Himansu; Sharma, Lokesh; Pursnani, Lalit; B, Muthukumar; Inamdar, Neeraj; Kaur, Navjot; Singh, Anamika; Krishnan, Chandra
• Is Part Of: Nephrology dialysis transplantation. Volume 36(2021)Supplement 1
• Publication Date: 2021-05-29
• Subjects: Nephrology -- Periodicals; Hemodialysis -- Periodicals; Kidneys -- Transplantation -- Periodicals; Hemodialysis; Kidneys -- Transplantation; Nephrology; Periodicals; 616.61
• DOI: 10.1093/ndt/gfab103.0016
• Languages: English
• ISSNs: 0931-0509

Abstract

Abstract: Background and Aims: The main hindrance in adequate utilization of Arteriovenous fistula (AVF) is its high rates of primary failure. Its etiology is multi factorial and several uremic toxins are under investigation. Here we explore the potential influence of Advanced Glycation End Products (AGE) and Human Indoxyl Sulphate (HIS) on AVF non maturation. Method: This one year prospective observational study included single stage AVF in consecutive CKD 4 and 5 patients. At baseline, demographic, biochemical (including AGE and HIS levels) and doppler ultrasound of upper limb were done followed by AVF construction. At 12 weeks, AVF was assessed for clinical maturation (usage of fistula with 2 needles for 75% of dialysis sessions during 15 day period); accordingly divided in to matured or non-matured groups. Demographic and biochemical parameters between both groups were compared; ROC and correlation of AGE and HIS were analyzed. Results: Of 129 AVF, 67.4% were matured and 32.5% non-matured. Overall mean age was 40.9 year, male predominance (77.5%) and more non-matured AVF among diabetes. The mean value of AGE and IS was 0.18 µg/ml and 0.18µg/ml respectively; but difference was non significant between two group. AGE levels were further showing positive correlation with CRP (p 0.01, r 0.21) and venous diameter (p 0.02, r -0.22). There were significant positive correlation between AGE and HIS (p<0.00, r 0.5) but not with other parameters. AUC of AGE and HIS were 0.48 and 0.5 respectively and association could not be demonstrated between all studied parameters and AVF outcome. Conclusion: Study cohort showed high incidence of primary failure without any association of AGE and HIS with clinical AVF non maturation.