title: Role of vascular function in predicting arteriovenous fistula outcomes: an observational pilot study.
abstract: BACKGROUND
  Many arteriovenous fistula (AVF) fail prior to use due to lack of maturation or thrombosis. Determining vascular function prior to surgery may be helpful to predict subsequent AVF success. This is a feasibility study to describe the vascular function in a cohort of chronic kidney disease (CKD) patients who are awaiting AVF creation.
  
  
  METHODS
  A prospective cohort of 28 CKD patients expected to progress to HD underwent arterial stiffness (pulse wave velocity, PWV) and endothelial function testing (flow mediated dilation FMD, and peripheral arterial tonometry, PAT) one week prior to AVF creation. AVF success was defined as maintaining patency and achieving maturation. Post operative fistula assessment at 8 weeks evaluated maturation (clinical assessment of adequate fistula flowand ultrasound diameter ≥ 0.5 cm).
  
  
  RESULTS
  The median age 72 years (62 - 78), 75% males, eGFR 15 ml/min/1.73 m(2) (12 - 18). 20 (71%) patients had successful AVF surgery with a mature AVF at 8 weeks. Patients with AVF success had higher mean PAT values 1.87 ± 0.52 than those with failed AVF 1.41 ± 0.24 p = 0.03.
  
  
  CONCLUSIONS
  Microvascular endothelial function as measured using PAT may be useful as a predictor of AVF maturation and function. This simple non invasive marker of vascular function may be a useful tool to predict AVF outcomes.
authors.affiliation: Division of Nephrology, Faculty of Medicine, University of Calgary, Calgary, Canada ; Department of Cardiac Sciences, Faculty of Medicine, University of Calgary, Calgary, Canada.
authors.forename: Jennifer M
authors.initials: JM
authors.lastname: MacRae
authors.affiliation: Division of Nephrology, Faculty of Medicine, University of Calgary, Calgary, Canada.
authors.forename: Sofia
authors.initials: S
authors.lastname: Ahmed
authors.affiliation: Division of Nephrology, Faculty of Medicine, University of Calgary, Calgary, Canada.
authors.forename: Brenda
authors.initials: B
authors.lastname: Hemmelgarn
authors.affiliation: Department of Cardiac Sciences, Faculty of Medicine, University of Calgary, Calgary, Canada.
authors.forename: Yichun
authors.initials: Y
authors.lastname: Sun
authors.affiliation: Department of Cardiac Sciences, Faculty of Medicine, University of Calgary, Calgary, Canada.
authors.forename: Billie-Jean
authors.initials: BJ
authors.lastname: Martin
authors.affiliation: Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada.
authors.forename: Idan
authors.initials: I
authors.lastname: Roifman
authors.affiliation: Department of Cardiac Sciences, Faculty of Medicine, University of Calgary, Calgary, Canada.
authors.forename: Todd
authors.initials: T
authors.lastname: Anderson
keywords: Arteriovenous fistula; Endothelial function; Peripheral arterial tonometry; Vascular reactivity