Preoperative Ratio of High-Sensitivity C-Reactive Protein to Albumin as a Predictor of Arteriovenous Fistula Failure

Overview

This study investigates the predictive value of the high-sensitivity C-reactive protein-to-albumin ratio (HRR) for arteriovenous fistula (AVF) failure in hemodialysis patients. The findings indicate that higher HRR is significantly associated with increased risk of AVF failure.

Background

Arteriovenous fistula (AVF) is the preferred vascular access for hemodialysis, yet failure rates can be as high as 50% within the first year. Identifying patients at risk for AVF failure is crucial for improving outcomes and optimizing resource allocation. The high-sensitivity C-reactive protein-to-albumin ratio (HRR) may serve as a marker reflecting inflammation and nutritional status, which are important factors in vascular health.

Data Highlights

Key Findings

• AVF failure occurred in 141 out of 279 patients (50.5%) during a median follow-up of 50 months.
• Each unit increase in HRR was associated with a 65% increased risk of AVF failure (HR = 1.65).
• Vessel diameter was also a significant predictor of AVF failure (HR = 0.21).
• Moderate model discrimination was observed at 24 months (AUC = 0.608).

Clinical Implications

The HRR may assist clinicians in identifying patients at higher risk for AVF failure, allowing for tailored surveillance and intervention strategies. Its use as a preoperative marker could enhance risk stratification in clinical practice.

Conclusion

The study demonstrates that preoperative HRR is an independent predictor of AVF failure.

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