title: Factors influencing dialysis arteriovenous graft survival.
abstract: OBJECTIVE
  Dysfunction and loss of patency of dialysis arteriovenous grafts (AVGs) are serious causes of morbidity in patients on dialysis. Various risk factors associated with shorter AVG patency have been blamed, but the results of the studies were controversial. The aim of this study was to assess if associated diseases, biochemical markers and other parameters associated with atherosclerosis influence patency of AVGs in a large vascular access centre.
  
  
  METHODS
  We conducted a retrospective study that included patients with AVGs patent for at least 3 weeks after creation. We included variables associated with atherosclerosis into the analysis (coronary artery disease, diabetes mellitus, chronic heart failure, arterial hypertension, smoking history and cholesterol and triglyceride levels) and characteristics of the graft (shape, feeding artery).The data was assessed using log-rank (Cox-Mantel) test. The differences were shown using Kaplan-Meier graphs. The observation period was limited to 1000 days after access creation.
  
  
  RESULTS
  Overall, 338 patients were included in the study. Significantly higher risk of access failure was associated with presence of coronary artery disease (p = 0.0035). Higher serum cholesterol levels were associated with longer survival of the graft in 1000 days of surveillance (p = 0.04).
  
  
  CONCLUSIONS
  Coronary artery disease negatively influences the cumulative patency of vascular access. Higher serum cholesterol levels are associated with lower AVG failure risk over a 1000-day period, which probably corresponds to the worse disease status of the patients with lower cholesterol values.
authors.affiliation: Centre for Vascular Access, Complex Cardiovascular Centre, General University Hospital and First Faculty of Medicine, Charles University, Prague - Czech Republic.
authors.forename: Anna
authors.initials: A
authors.lastname: Valerianova
authors.affiliation: Centre for Vascular Access, Complex Cardiovascular Centre, General University Hospital and First Faculty of Medicine, Charles University, Prague - Czech Republic.
authors.forename: Jaroslav
authors.initials: J
authors.lastname: Kudlicka
authors.affiliation: Centre for Vascular Access, Complex Cardiovascular Centre, General University Hospital and First Faculty of Medicine, Charles University, Prague - Czech Republic.
authors.forename: Eva
authors.initials: E
authors.lastname: Chytilova
authors.affiliation: Centre for Vascular Access, Complex Cardiovascular Centre, General University Hospital and First Faculty of Medicine, Charles University, Prague - Czech Republic.
authors.forename: Barbora
authors.initials: B
authors.lastname: Grauova
authors.affiliation: Centre for Vascular Access, Complex Cardiovascular Centre, General University Hospital and First Faculty of Medicine, Charles University, Prague - Czech Republic.
authors.forename: Zdislava
authors.initials: Z
authors.lastname: Krupickova
authors.affiliation: Centre for Vascular Access, Complex Cardiovascular Centre, General University Hospital and First Faculty of Medicine, Charles University, Prague - Czech Republic.
authors.forename: Jan
authors.initials: J
authors.lastname: Malik
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001166:Arteriovenous Shunt, Surgical / Q000009:adverse effects / Q000379:methods*; D015415:Biomarkers / Q000097:blood; D002784:Cholesterol / Q000097:blood; D015897:Comorbidity; D003324:Coronary Artery Disease / Q000453:epidemiology; D018153:Czech Republic / Q000453:epidemiology; D050171:Dyslipidemias / Q000097:blood / Q000453:epidemiology; D005260:Female; D006083:Graft Occlusion, Vascular / Q000453:epidemiology / Q000503:physiopathology; D006304:Health Status; D006785:Hospitals, University; D006801:Humans; D053208:Kaplan-Meier Estimate; D007676:Kidney Failure, Chronic / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D006435:Renal Dialysis; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D014654:Vascular Patency; D055815:Young Adult
chemical_list: D015415:Biomarkers; D002784:Cholesterol