MO772: Elevated C-Reactive Protein Level and Vascular Access Failure in End-Stage Renal Disease Patients: A Systematic Review and Meta-Analysis

Abstract

Abstract BACKGROUND AND AIMS Vascular access (VA) failure is common and can be fatal in hemodialysis (HD) patients with arteriovenous fistula (AVF) or arteriovenous graft (AVG). Most recent studies found that elevated C-reactive protein (CRP) level was associated with VA failure of AVF or AVG, although this is controversial, and have not been systematically reviewed. METHOD We systematically searched PubMed, Web of Science and Cochrane Library from inception until June 2021 for cohort and case-control studies on elevated CRP levels and VA failure in hemodialysis patients with AVF or AVG. We conducted a meta-analysis on the relative risk (RR) of VA failure and elevated CRP levels. An additional search of the Science Citation Index Expanded on the Web of Science and references lists were reviewed. RESULTS Of 2974 reports identified, 24 studies met inclusion criteria, most with high quality. We included 24 studies in the VA failure systematic review and 15 studies in the meta-analysis. A total of 12 cohort studies providing data for 4011 patients and 3 case-control studies providing data for 473 patients were reflected in the present meta-analysis. The risk of VA failure was higher [RR:1.14, 95% confidence interval (95% CI): 1.07–1.22] in the subjects with elevated CRP levels than in those with normal levels. CONCLUSION Elevated CRP level was associated with a higher risk of VA failure in hemodialysis patients with AVF/AVG.