Homocysteine and vascular access thrombosis in hemodialysis patients.
BACKGROUND
Vascular access remains the Achilles' heel of successful hemodialysis, and thrombosis is the leading cause of vascular access failure. Hyperhomocystinemia is common in hemodialysis patients and is associated with venous and arterial thrombosis in patients without end-stage renal disease.


METHODS
In the study, 65 hemodialysis patients with native arteriovenous fistula were included. Two groups of patients were defined: group A including 45 patients with their vascular access either never or only once thrombosed, and group B including 20 patients with two or more thromboses of their vascular access. We determined serum concentrations of total homocysteine (immunoassay, Abbott) in our patients.


RESULTS
In 63 (96.9%) patients, hyperhomocystinemia was presented. There was no statistically significant difference between group A and B regarding age, gender and duration of hemodialysis treatment. Total homocysteine concentrations were higher in group A (42.1 +/- 18.6 micromol/l) than in group B (36.1 +/- 18.1 micromol/l) patients but the difference was small and not statistically significant.


CONCLUSIONS
We found no significant differences in total homocysteine concentrations between group A (thrombosis non-prone) and group B (thrombosis prone) patients. Our results suggest that thrombosis of native arteriovenous fistulas may not be caused by hyperhomocystinemia in these patients.
Hojs
Radovan
R
Department of Nephrology, Teaching Hospital Maribor, Slovenia. Radovan.Hojs@sb-mb.si
Gorenjak
Maksimiljan
M
Ekart
Robert
R
Dvorsak
Benjamin
B
Pecovnik-Balon
Breda
B
D000328:Adult; D000368:Aged; D001164:Arteriovenous Fistula / Q000097:blood* / Q000150:complications*; D002408:Catheters, Indwelling / Q000009:adverse effects*; D005260:Female; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D020138:Hyperhomocysteinemia / Q000097:blood* / Q000150:complications*; D007676:Kidney Failure, Chronic / Q000097:blood* / Q000150:complications* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis / Q000009:adverse effects*; D012307:Risk Factors; D013997:Time Factors; D020246:Venous Thrombosis / Q000097:blood* / Q000209:etiology*
D006710:Homocysteine