title: The independent association of preoperative serum albumin on the functional maturation of radiocephalic arteriovenous fistulae.
abstract: OBJECTIVE
  The aim of this study is to test the null hypothesis that preoperative albumin along with other preoperative confounders have no impact on the functional maturation of radiocephalic arteriovenous fistulae (RCAVF).
  
  
  METHODS
  A retrospective cohort study of n = 195 individuals undergoing RCAVF formation from July 2013 to December 2015 was conducted. The null hypothesis was assessed through chi squared test. Independent association of each variable was evaluated through univariate and multivariate logistic regression model. Pearson's correlation test was also performed between scale variables to establish their causal link.
  
  
  RESULTS
  Preoperative hypoalbuminaemic group of individuals demonstrated significant failure of maturation (49.3% vs. 27.2%, p = 0.002). At multivariate analysis, hypoalbuminemia remained an independent marker of fistula failure (OR 0.40, 95% CI 0.21-0.76, p = 0.004) and demonstrated a weak but a positive correlation at the endpoint of maturation (R = 0.223, p = 0.002).
  
  
  CONCLUSIONS
  Preoperative hypoalbuminemia (<35 mg/dL) is independently associated with 40% reduction in the functional maturation of RCAVF. Stratification of this readily available biomarker prior to RCAVF formation may require consideration subjected to further research.
authors.affiliation: Department of Vascular, Endovascular and Renal Access, Mid-Essex Hospital Services NHS Trust Broomfield Hospital, Essex - UK.|Medical Sciences, Anglia Ruskin University, Cambridge - UK.
authors.forename: Ali
authors.initials: A
authors.lastname: Kordzadeh
authors.affiliation: Department of Vascular, Endovascular and Renal Access, Mid-Essex Hospital Services NHS Trust Broomfield Hospital, Essex - UK.
authors.forename: Evripidis
authors.initials: E
authors.lastname: Tokidis
authors.affiliation: Department of Surgery, Ipswich Hospital, Ipswich, Suffolk - UK.
authors.forename: Alan
authors.initials: A
authors.lastname: Askari
authors.affiliation: Medical Sciences, Anglia Ruskin University, Cambridge - UK.
authors.forename: Mekhola
authors.initials: M
authors.lastname: Hoff
authors.affiliation: Department of Vascular, Endovascular and Renal Access, Mid-Essex Hospital Services NHS Trust Broomfield Hospital, Essex - UK.
authors.forename: Yiannis
authors.initials: Y
authors.lastname: Panayiotopoulos
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001166:Arteriovenous Shunt, Surgical / Q000009:adverse effects; D015415:Biomarkers / Q000097:blood; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D034141:Hypoalbuminemia / Q000097:blood / Q000150:complications* / Q000175:diagnosis; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D017534:Radial Artery / Q000601:surgery*; D006435:Renal Dialysis; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012709:Serum Albumin / Q000032:analysis*; D000075462:Serum Albumin, Human; D013997:Time Factors; D016896:Treatment Outcome; D034941:Upper Extremity / Q000098:blood supply*; D014654:Vascular Patency; D014680:Veins / Q000601:surgery*; D055815:Young Adult
chemical_list: C422455:ALB protein, human; D015415:Biomarkers; D012709:Serum Albumin; D000075462:Serum Albumin, Human