Abstract: FR-PO517
Presurgery Plasma Metabolites Are Associated with Arteriovenous Fistula Maturation Outcomes
Session Information
- Dialysis Vascular Access
October 25, 2024 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 803 Dialysis: Vascular Access
Authors
- Wang, Xin, Renal Research Institute, New York, New York, United States
- Zaidi, Syed Shaukat Abbas, Manchester Royal Infirmary, Manchester University NHS Foundation Trust, Manchester, United Kingdom
- Chan, Cindy, Fresenius Medical Care Asia Pacific Ltd, Hong Kong, Hong Kong
- Cheung, Yan Yi, Global Medical Office, Fresenius Medical Care, Singapore, Singapore
- Grobe, Nadja, Renal Research Institute, New York, New York, United States
- Kotanko, Peter, Renal Research Institute, New York, New York, United States
- Mitra, Sandip, Manchester Royal Infirmary, Manchester University NHS Foundation Trust, Manchester, United Kingdom
- Nikam, Milind, Global Medical Office, Fresenius Medical Care, Singapore, Singapore
Background
Arteriovenous fistulas (AVFs) are the preferred vascular access for most hemodialysis (HD) patients. Previously, we showed that plasma metabolome clusters prior to AVF surgery associate with AVF maturation outcomes. Here we aim to further annotate pre-surgery plasma metabolites as potential biomarkers of AVF maturation outcomes.
Methods
Successful AVF maturation was defined as either adequate HD or a combination of ultrasound features (vein size > 4 mm with AVF flow ≥ 500 ml/min) and clinical assessment. Pre-surgery plasma samples from the day of AVF creation surgery were analyzed by liquid chromatography-mass spectrometry. Metabolites were identified by matching to in-house and METLIN libraries.
Results
The study cohort included 28 patients with successful AVF maturation and 16 with AVF failure. We annotated 147 metabolites in the pre-surgery plasma samples. In patients with successful AVF maturation, 5 were significantly up-regulated and 4 were down-regulated (Fig. 1). The metabolites are linked to the metabolism of lipids, amino acids, or starch. Four of the 9 metabolites are acylcarnitines, which are responsible for transporting fatty acids into the mitochondria for β-oxidation, suggesting a role of energy metabolism in AVF maturation. AVF maturation outcomes did not correlate with age, sex, diabetes, and cardiovascular disease.
Conclusion
Nine pre-surgery plasma metabolites were differentially regulated between patients with successful or failed AVF maturation. If validated by further targeted analysis and corroborated in larger cohorts, these potential biomarkers could inform precision vascular access planning.
Funding
- Commercial Support – Renal Research Institute, Fresenius Medical Care