title: IgM-anticardiolipin antibody and vascular access thrombosis in chronic hemodialysis patients.
abstract: OBJECTIVE
  Vascular access failure is a major cause of morbidity in chronic hemodialysis (HD) patients. Elevated immunoglobulin-M anticardiolipin antibody (IgM-aCL) titer is associated with stenosis of vascular access in HD patients. The clinical significance of elevated IgM-aCL titer relative to recurrent vascular access thrombosis (VAT) in patients with HD is less clear. However, little information has been available until now about the clinical influence of elevated IgM-aCL titer with recurrent VAT in HD patients from Western countries, and no report exists for Taiwan. This study attempted to determine whether elevated IgM-aCL titer was associated with recurrent VAT in HD patients.
  
  
  METHODS
  This study enrolled 483 patients undergoing HD. IgM-aCL titer and hepatitis C marker were measured for all subjects.
  
  
  RESULTS
  Elevated IgM-aCL titer was present in 17.4% (84/483) of patients. There was no association recurrent VAT between elevated and normal IgM-aCL titers (P=0.90). Presence of hepatitis C had significant differences between elevated and normal IgM-aCL titers (P=0.027).
  
  
  CONCLUSIONS
  We found no significant differences in recurrent VAT between elevated and normal IgM-aCL titer in chronic HD patients. Our results suggest recurrent VAT of synthetic or native fistula may not be caused by elevated IgM-aCL titer in these patients. Presence of hepatitis C may be a cofactor.
authors.affiliation: Chang Gung Memorial Hospital, Kaohsiung Medical Center, Kaohsiung, Taiwan.
authors.forename: Feng-Rong
authors.initials: FR
authors.lastname: Chuang
authors.forename: Te-Chuan
authors.initials: TC
authors.lastname: Chen
authors.forename: Chih-Chao
authors.initials: CC
authors.lastname: Yang
authors.forename: Yuan-Fu
authors.initials: YF
authors.lastname: Cheng
authors.forename: Kuo-Tai
authors.initials: KT
authors.lastname: Hsu
authors.forename: Chih-Hsiung
authors.initials: CH
authors.lastname: Lee
authors.forename: Chun-Liang
authors.initials: CL
authors.lastname: Lin
authors.forename: I-Kuan
authors.initials: IK
authors.lastname: Wang
authors.forename: Hsueh-Wen
authors.initials: HW
authors.lastname: Chang
authors.forename: Pao-Hui
authors.initials: PH
authors.lastname: Wang
mesh_terms: D017153:Antibodies, Anticardiolipin / Q000097:blood / Q000276:immunology*; D001166:Arteriovenous Shunt, Surgical / Q000009:adverse effects*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007075:Immunoglobulin M / Q000097:blood / Q000276:immunology; D007676:Kidney Failure, Chronic / Q000276:immunology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D006435:Renal Dialysis; D013927:Thrombosis / Q000276:immunology*
chemical_list: D017153:Antibodies, Anticardiolipin; D007075:Immunoglobulin M