抗磷脂抗体阳性与原发性动静脉瘘的成熟失败和血栓形成有关:一项针对 HD 患者的回顾性研究。

IF 3.9 2区 医学 Q1 UROLOGY & NEPHROLOGY Clinical Kidney Journal Pub Date : 2024-10-15 eCollection Date: 2024-11-01 DOI:10.1093/ckj/sfae308
Maxime Taghavi, Lucas Jacobs, Anne Demulder, Abla Jabrane, Maria Do Carmo Filomena Mesquita, Catherine Defawe, Marc Laureys, Yves Dernier, Agnieszka Pozdzik, Frédéric Collart, Joëlle Nortier
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引用次数: 0

摘要

背景和假设:与普通人群相比,血液透析(HD)患者中抗磷脂抗体(aPL)的发病率较高,而且与动静脉瘘(AVF)血栓形成或狭窄的关系并不一致。与成熟失败的关系还从未被研究过。本研究旨在评估 aPL 阳性 HD 患者的原发性动静脉瘘并发症(血栓形成、狭窄和成熟失败)和原发性通畅率:方法:我们回顾性地确定了 116 名患有原发性动静脉瘘的 HD 患者。我们收集了 aPL 资料、可能与 AVF 成熟失败、血栓形成和狭窄有关的临床和生物学数据,并研究了这些并发症与 aPL 阳性的关系。结果显示,在我们的队列中,aPL 阳性的发生率为 0.5%:在我们的队列中,aPL 持续阳性的发生率为 32.7%,这与超声定义的动静脉瓣膜成熟失败密切相关。aPL 持续阳性在多变量分析中是一个很强的预测因子,这种关联与成熟过程中的动静脉瓣膜狭窄或血栓形成无关。与原发性和功能性原发性通畅以及狭窄没有关联。然而,与严格阴性的 aPL 患者相比,根据 ACR/EULAR 分类标准,aPL 持续阳性与血栓形成有关:结论:在我们的队列中,aPL持续阳性与动静脉瘘成熟失败和血栓形成显著相关,但与动静脉瘘狭窄无关。据我们所知,我们首次报告了 aPL 阳性与本地动静脉瓣膜成熟延迟或缺失之间具有统计学意义的关联。
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Antiphospholipid antibody positivity is associated with maturation failure and thrombosis of native arteriovenous fistula: a retrospective study in HD patients.

Background and hypothesis: The prevalence of antiphospholipid antibody (aPL) is high among hemodialysis (HD) patients compared to the general population and is inconsistently associated with arteriovenous fistula (AVF) thrombosis or stenosis. The association with maturation failure has never been investigated. This study aims to evaluate native AVF complications (thrombosis, stenosis, and maturation failure) and primary patency in aPL positive HD patients.

Methods: We retrospectively identified 116 HD patients with native AVF. We collected the aPL profiles, the clinical and biological data potentially involved in AVF maturation failure, thrombosis, and stenosis, and investigated the association of these complications and aPL positivity. Kaplan-Meier survival analysis was performed.

Results: In our cohort, the prevalence of aPL persistent positivity was 32.7% and this was strongly associated with AVF maturation failure defined by ultrasound. aPL persistent positivity was a strong predictor in multivariate analysis and this association was independent of AVF stenosis or thrombosis during maturation process. There was no association with primary and functional primary patency, and stenosis. However, aPL persistent positivity according to ACR/EULAR classification criteria was associated with thrombosis when compared to strictly negative aPL patients.

Conclusions: In our cohort, aPL persistent positivity was significantly associated with AVF maturation failure and thrombosis but not with AVF stenosis. To our knowledge, we report for the first time, a statistically significant association between aPL positivity and delay or absence of native AVF maturation.

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来源期刊
Clinical Kidney Journal
Clinical Kidney Journal Medicine-Transplantation
CiteScore
6.70
自引率
10.90%
发文量
242
审稿时长
8 weeks
期刊介绍: About the Journal Clinical Kidney Journal: Clinical and Translational Nephrology (ckj), an official journal of the ERA-EDTA (European Renal Association-European Dialysis and Transplant Association), is a fully open access, online only journal publishing bimonthly. The journal is an essential educational and training resource integrating clinical, translational and educational research into clinical practice. ckj aims to contribute to a translational research culture among nephrologists and kidney pathologists that helps close the gap between basic researchers and practicing clinicians and promote sorely needed innovation in the Nephrology field. All research articles in this journal have undergone peer review.
期刊最新文献
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