Atrial fibrillation linked to vascular access thrombosis in chronic hemodialysis patients

Aim: atrial fibrillation (af) is characterized by the development of thromboembolic events and is more prevalent among end-stage renal disease patients than in the general population. vascular access thrombosis (vat) is a major morbidity in chronic hemodialysis (hd) patients; however,the association between af and vat is unknown. methods: we retrospectively reviewed chronic hd patients with functional vascular access between 1997 and 2006. the association between af and the development of vat was analyzed using kaplan-meier analysis and multivariate cox proportional hazards regression. results: a total of 568 chronic hd patients,including 55 (9.7%) patients with af,were reviewed and 154 (27.1%) patients developed at least one episode of vat. patients with af had worse vat- free survival than patients without af (p<0.001). in cox regression,age,type of vascular access,atrial fibrillation,diabetes,hypertension,and c-reactive protein were independently linked to the de- velopment of vat (p 0.049,<0.001,<0.001,0.001,0.028 and 0.045). the hazard ratios were 2.1 (95% ci: 1.00-1.03) for arteriovenous graft,2.47 (95% ci: 1.66-3.69) for af,1.72 (95% ci: 1.25-2.39) for diabetes and 1.09 (95% ci: 1.00-1.18) for serum c-reactive protein (every 1 mg/dl increase),respectively. conclusion: atrial fibrillaiton is linked to the development of vascular access thrombosis in chronic hemodialysis patients and is independent of traditional vat risk factors.