title: Arteriovenous fistula aneurysm in patients on regular hemodialysis: prevalence and risk factors.
abstract: OBJECTIVE
  Compared to all other complications, literature data about vascular access aneurysm (VAA) are the scarcest. The aim of this cross-sectional study was to evaluate the prevalence of arteriovenous fistula (AVF) aneurysms and to confirm the risk factors for their appearance.
  
  
  METHODS
  The presence, number and morphological characteristics of AVF aneurysms were confirmed, and according to the score of AVF aneurysm (the sum of the length and width in cm), patients were classified into group 1 (score ≤12) and group 2 (score >12). Analysis included the last data from the medical records including vascular calcifications score.
  
  
  RESULTS
  Out of 181 patients, 150 with native fistula were included in this study. Aneurysmatic changes were detected in 90 (60%) patients, and the majority had two or more aneurysms. VAA were more frequent in patients with adult polycystic kidney disease (ADPKD) than in other diagnostic categories. By using forward stepwise logistic regression, we confirmed that patients on high-flux hemodialysis (HD) had 5.3-fold higher risk, and patients with diabetes mellitus had 5.8-fold less risk for developing AVF aneurysm. While vascular calcification score did not influence the incidence of VAA, higher PWV had significant negative influence on formation of AVF aneurysm (OR 1.25, 95% CI 1.003-1.56, p = 0.047). By ROC curve analysis, it was determined that patients who were longer than 5.7 years on HD had greater risk for developing VAA (area = 0.741, p = 0.000).
  
  
  CONCLUSIONS
  This single-center study confirmed the very high prevalence of VAA (60%). Aneurysms were more frequent in patients with ADPKD and in those who had longer dialysis vintage on high-flux membranes with higher blood flow rate.
authors.affiliation: Clinical Department for Renal Diseases, Zvezdara University Medical Center, Belgrade, Serbia.
authors.forename: Aleksandar
authors.initials: A
authors.lastname: Jankovic
authors.forename: Branislav
authors.initials: B
authors.lastname: Donfrid
authors.forename: Jelena
authors.initials: J
authors.lastname: Adam
authors.forename: Marjan
authors.initials: M
authors.lastname: Ilic
authors.forename: Zivka
authors.initials: Z
authors.lastname: Djuric
authors.forename: Tatjana
authors.initials: T
authors.lastname: Damjanovic
authors.forename: Jovan
authors.initials: J
authors.lastname: Popovic
authors.forename: Gordana
authors.initials: G
authors.lastname: Popovic
authors.forename: Zoran
authors.initials: Z
authors.lastname: Radojicic
authors.forename: Nada
authors.initials: N
authors.lastname: Dimkovic
mesh_terms: D017677:Age Distribution; D000783:Aneurysm / Q000453:epidemiology*; D001166:Arteriovenous Shunt, Surgical / Q000706:statistics & numerical data*; D015984:Causality; D015897:Comorbidity; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000453:epidemiology* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D006435:Renal Dialysis / Q000706:statistics & numerical data*; D012307:Risk Factors; D055771:Serbia / Q000453:epidemiology; D017678:Sex Distribution; D016896:Treatment Outcome