TITLE: Prognosis of Vascular Access in Haemodialysis Patients with Autosomal Dominant Polycystic Kidney Disease.

ABSTRACT: Vascular diseases are commonly observed in patients with autosomal dominant polycystic kidney disease (ADPKD). We aim to investigate the differences in the risk for arteriovenous fistula or graft (AVF/AVG) dysfunction in haemodialysis (HD) patients with and without ADPKD. 557 ADPKD and 1671 non-ADPKD patients were enrolled in the study after propensity score matching. The primary outcome measure is the incidence rate of AVF/AVG dysfunction. The incidence rates and risks of AVF/AVG dysfunction (per 100 person-years) for ADPKD and non-ADPKD patients were (1) 38.83 and 48.99 [SHR = 0.79, P = 0.137], respectively, for within 90 days, (2) 45.85 and 51.31 [SHR = 0.90, P = 0.300], respectively, for within 180 days, (3) 44.42 and 41.40 [SHR = 1.08, P = 0.361], respectively, for within the first year, (4) 27.38 and 24.69 [SHR = 1.09, P = 0.168], respectively, for within 5 years, (5) 17.35 and 13.80 [SHR = 1.19, P = 0.045], respectively, for between the 1st and 10th year, and (6) 25.40 and 21.22 [SHR = 1.14, P = 0.031], respectively, for all periods. ADPKD patients had lower incidence rates of AVF/AVG dysfunction within the first 180 days than non-ADPKD patients, but presented a higher incidence rate after 1 year of AVF/AVG creation and onwards.

SOURCE: Lee TL, Chen CF, Tan AC, et al. Prognosis of Vascular Access in Haemodialysis Patients with Autosomal Dominant Polycystic Kidney Disease[J]. Sci Rep, 2020, 10(1):1985. DOI: 10.1038/s41598-020-58441-5.

常染色体显性遗传性多囊肾（ADPKD）患者通常观察到血管疾病。我们旨在调查在有或没有ADPKD的血液透析（HD）患者中动静脉瘘或移植物（AVF / AVG）功能障碍风险的差异。倾向得分匹配后，纳入557位ADPKD和1671位非ADPKD患者。主要结局指标是AVF / AVG功能障碍的发生率。ADPKD和非ADPKD患者的AVF / AVG功能障碍（每100人年）的发生率和风险:

在90天内，为（1）38.83和48.99 [SHR = 0.79，P = 0.137]，

180天之内分别（2 ）为45.85和51.31 [SHR = 0.90，P = 0.300]，

第一年之内分别为（3）44.42和41.40 [SHR = 1.08，P = 0.361]，

五年内分别为（4）27.38和24.69 [SHR = 1.09，P = 0.168]，

第一年至10年之间分别为（5）17.35和13.80 [SHR = 1.19，P = 0.045]，

以及所有时段分别为（6）25.40和21.22 [SHR = 1.14，P = 0.031]。

与非ADPKD患者相比，ADPKD患者在头180天内AVF / AVG功能障碍的发生率较低，但是在创建AVF / AVG 1年及以后，ADPKD患者的发生率较高。

启发: 只有从比较中去看发生率差异，单独看的意义不同，ADPKD在长期功能障碍发生率更高，但原因暂不清楚，本文特点在于数据量大，影响因素切入点有新意。