title: Arterial stiffness and arteriovenous fistula failure of maturation.
abstract: OBJECTIVE
  Increased arterial stiffness is a common finding in patients with end-stage renal disease. Following creation of an arteriovenous fistula (AVF), appropriate dilation of the feeding artery must occur to facilitate AVF maturation. Arterial stiffness may impair the arterial dilation required to facilitate AVF development and contribute to subsequent failure to mature (FTM). The aim of this pilot study was to investigate the association between measurements of central and peripheral arterial stiffness, and AVF FTM.
  
  
  METHODS
  Patients undergoing AVF creation in a single centre (Belfast City Hospital, UK) between January and December 2015 were invited to have their carotid-femoral pulse wave velocity (PWV), brachial-radial PWV and augmentation index (AI) measured prior to AVF creation. Subsequent AVF outcomes were identified.
  
  
  RESULTS
  Fifty-nine patients who had an AVF procedure were included in the final analysis (mean age 62 years); 50.8% had diabetes mellitus. The mean pre-operative arterial diameter for all AVFs was 3.9 mm. Average values for carotid-femoral PWV were 9.5 m/s, brachial-radial PWV 7.7 m/s and AI 25.6%. Using logistic regression, these arterial stiffness parameters did not predict AVF FTM: carotid-femoral PWV (P = 0.20), brachial-radial PWV (P = 0.13), AI (P = 0.50).
  
  
  CONCLUSIONS
  This is the largest study to date exploring the association between arterial stiffness and AVF FTM. The measured central and peripheral arterial stiffness parameters were not associated with AVF FTM. Further research is needed to define if non-invasive arterial physiological measurements would be clinically useful in the prediction of AVF FTM.
authors.affiliation: Regional Nephrology Unit, Belfast City Hospital, Belfast - UK.|Nephrology Research Group, Centre for Public Health, Queen's University Belfast, Royal Victoria Hospital, Belfast - UK.
authors.forename: Agnes
authors.initials: A
authors.lastname: Masengu
authors.affiliation: Regional Nephrology Unit, Belfast City Hospital, Belfast - UK.
authors.forename: Jennifer B
authors.initials: JB
authors.lastname: Hanko
authors.affiliation: Regional Nephrology Unit, Belfast City Hospital, Belfast - UK.|Nephrology Research Group, Centre for Public Health, Queen's University Belfast, Royal Victoria Hospital, Belfast - UK.
authors.forename: Alexander P
authors.initials: AP
authors.lastname: Maxwell
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001166:Arteriovenous Shunt, Surgical / Q000009:adverse effects*; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009660:Northern Ireland; D010865:Pilot Projects; D063177:Pulse Wave Analysis; D006435:Renal Dialysis; D012307:Risk Factors; D017211:Treatment Failure; D059289:Vascular Stiffness; D055815:Young Adult