Abstract: FR-PO532
Comparative Analysis of Anti-phospholipid-Antibody Positivity and Confirmation as Potential Risk Factors for Arteriovenous Fistula Thrombosis in Patients on Hemodialysis
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
- Taghavi, Maxime, UVC Brugmann - Site Victor Horta, Brussels, Belgium
- Jacobs, Lucas, UVC Brugmann - Site Victor Horta, Brussels, Belgium
- Collart, Frederic, UVC Brugmann - Site Victor Horta, Brussels, Belgium
- Nortier, Joelle L., UVC Brugmann - Site Victor Horta, Brussels, Belgium
Background
The classification criteria (CC) for antiphospholipid syndrome require antiphospholipid antibody (aPL) persistent positivy (aPL PP)(i.e. confirmation assay at 12 weeks). aPL PP frequent in hemodialysis (HD) (prevalence up to 56%) and seems to be associated with native arteriovenous fistula (AVF) thrombosis, but studies have a heterogeneous aPL positivity definition. This study aims compare real-life situation of aPL positivity in terms of AVF thrombosis.
Methods
We retrospectively identified 127 HD patients with native AVF. We performed Kaplan-Meier analyses and compared AVF thrombosis prevalence during the follow-up. We evaluated different subgroups of patients representative of real-world practice: Analysis 1 according to CC; Analysis 2 comparing all patients with at least one positive aPL assay to strictly negative patients and analysis 3 comparing 'aPL PP according to CC' and 'patients with one aPL positive assay' and 'strictly negative patients'.
Results
aPL PP represented 30% of the cohort, only 8% of the patients were aPL+ once (without confirmation) and 16% were aPL+ with a negative control. The prevalence of AVF thrombosis was significantly higher in analysis 2 and tended to signification in analysis 3. Kaplan-Meier analysis showed significant shorter access survival without thrombosis from AVF first cannulation in analyses 2 and 3 (Mean time to first event (months ± SD) was 115.8 ± 12.7 vs 124.0 ± 6.6 in analysis 2 and 124.0 ± 6.6 vs 128.6 ± 15.1 in analysis 3 (Figure 1)).
Conclusion
The present in-depth comparative analysis of different aPL profiles encountered in real life situations, shows an significant associated with AVF thrombosis. Detection of aPL positivity could be a useful tool for the clinicians in assessing AVF thrombosis risk.