#5737 THE ASSOCIATION OF SERUM IRISIN WITH EARLY PATENCY LOSS OF ARTERIOVENOUS FISTULA

Abstract

Abstract Background and Aims In patients receiving hemodialysis (HD), arteriovenous fistula (AVF) is the preferred form of vascular access owing to its long-term patency and low risk of infection. Early patency loss of AVF (≤1 year) is associated with higher risk of mortality and morbidity. Irisin is thought to play a protective role in the regulation of endothelial function and vascular calcification. However, the relationship between serum irisin level and early patency loss of AVF is unclear. Method In 73 end-stage kidney disease (ESKD) patients, including pre-dialysis patients who receive AVF placement for the first time (n = 10), HD patients with early patency loss of AVF (n = 24), HD patients that lose AVF function more than 1 year (n = 39), fasting (>8 hours) serum irisin levels and other biochemical parameters (hemoglobin, serum albumin, calcium, phosphate, intact parathyroid hormone, triglyceride, total cholesterol, D-Dimer, fibrinogen, FGF23, C-reactive protein) were measured before receiving access placement or after AVF thrombosis. All patients had radial-cephalic fistula. Results Among 73 patients (median age 58 years, 60.3% male, 31.5% diabetes mellitus (DM)), patients with early patency loss of AVF had significantly higher serum irisin levels, and lower fibrinogen, compared with other two groups. Other characteristics had no significant difference among these three groups (shown in Table 1). Conclusion HD patients with early patency loss of AVF had higher serum irisin levels compared with pre-dialysis patients and HD patients whose AVF patency maintained more than 1 year. The increase of irisin may be related to its putative role in compensatory mechanisms against vascular injury, which is then lost with longer dialysis duration and aggravated vascular damage.