Prothrombotic risk factors in patients with recurrent thrombosis of the arteriovenous fistula

Abstract

Background. Arteriovenous (AV) fistula thrombosis is a common and expensive complication. In this study, we aimed to investigate the role of prothrombotic risk factors in the development of recurrent AV fistula thrombosis. PatientsandMethods. We evaluated 11 patients with chronic renal failure and recurrent thrombosis of their AV fistula who were referred to the Hacettepe University Faculty of Medicine Pediatric Hematology Unit between January 1998 and June 2005 for prothrombotic risk factors. Results. Of the 11 patients, 6 were children (mean age, 14.8 � 2.6 years), and 5 were adults (mean age, 37.6 � 16.6 years). All patients had had at least 2 episodes of thrombosis in their AV fistula, with an overall total of 31 episodes (mean: 2.8 � 1.3 episodes, range: 2–6 episodes). Eight of the 11 patients (72.7%) had at least one prothrombotic risk factor. Two patients (18.2%) had FV G1691A mutations, and two (18.2%) had prothrombin G20210A mutations. These mutations are more common in patients with recurrent AV fistula thrombosis than in a healthy Turkish population (18.2% versus 7.1% for the FV G1691A mutation and 18.2% versus 2.2% for the prothrombin G20210A mutation; p < 0.05). Conclusion. Recurrent AV fistula thrombosis should be considered as important as other types of recurrent thrombosis, and hereditary prothrombotic risk factors should be investigated to detect patients who have a thrombotic tendency in countries where these hereditary risk factors are common.