Evaluation of circulating vascular endothelial growth factor and soluble adhesion molecules as reliable predictors of native arteriovenous fistula thrombosis in chronic hemodialysis patients.

OBJECTIVES

We evaluated the possibility of using circulating vascular endothelial growth factor (VEGF) and soluble adhesion molecules as reliable predictors of native arteriovenous (AV) fistula thrombosis in chronic hemodialysis (HD) patients.

DESIGN AND METHODS

This study included 62 HD patients (34 with thrombosed and 28 with non-thrombosed AV fistulas) and 21 healthy volunteers. Serum VEGF, soluble vascular cell adhesion molecule-1 (sVCAM-1), soluble intercellular adhesion molecule-1 (sICAM-1), and soluble E-selectin (sE-selectin) were measured using ELISA technique.

RESULTS

VEGF, sVCAM-1, sICAM-1 and sE-selectin median levels were higher in HD patients compared to controls (p=0.000 for all parameters). Increased median levels of VEGF and sVCAM-1 were demonstrated in HD patients with thrombosed AV fistulas compared to HD patients with non-thrombosed AV fistulas (p=0.003 and 0.000, respectively). A significant positive correlation has been found between VEGF and sVCAM-1 in HD patients with thombosed AV fistulas (r=0.525, p=0.001).

CONCLUSIONS

The assessment of serum VEGF and sVCAM-1 might be useful for the identification of the chronic HD patients at an increased risk for native AV fistulas thrombosis. The clinical relevance of these observations warrants further investigations.