Retrospective analysis of statin use and arteriovenous fistula thrombosis in hemodialysis: Is there a dose-dependent effect?
Arteriovenous fistula (AVF) thrombosis is a major vascular access complication in hemodialysis (HD) patients, contributing to increased morbidity. Statins, known for their pleiotropic effects, may reduce AVF thrombosis risk, but evidence on dose-dependent effects is limited. This study evaluated th...
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National Kidney Foundation of Ukraine
2025-04-01
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| Series: | Український Журнал Нефрології та Діалізу |
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| Online Access: | https://ukrjnd.com.ua/index.php/journal/article/view/952 |
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| author | Natalia Stepanova Tetyana Ostapenko Valeriia Marchenko Alina Holovanova Mariia Lysii Tetyana Kucher Viacheslav Filonov Victor Dzhur Bohdan Stetsenko Hanna Moroid Nataliia Pavchak Kateryna Rusyn Oksana Rusyn Bohdan Radiuk |
| author_facet | Natalia Stepanova Tetyana Ostapenko Valeriia Marchenko Alina Holovanova Mariia Lysii Tetyana Kucher Viacheslav Filonov Victor Dzhur Bohdan Stetsenko Hanna Moroid Nataliia Pavchak Kateryna Rusyn Oksana Rusyn Bohdan Radiuk |
| author_sort | Natalia Stepanova |
| collection | DOAJ |
| description |
Arteriovenous fistula (AVF) thrombosis is a major vascular access complication in hemodialysis (HD) patients, contributing to increased morbidity. Statins, known for their pleiotropic effects, may reduce AVF thrombosis risk, but evidence on dose-dependent effects is limited. This study evaluated the association between statin use, dose intensity, and AVF thrombosis in HD patients.
Methods. A multicenter, retrospective cohort study was conducted using data from 562 HD patients with native AVFs across 10 dialysis clinics (May 2021–April 2025). Patients were categorized by statin use (users vs. non-users) and dose intensity (moderate vs. high vs. none). The primary outcome was AVF thrombosis; death was treated as a competing event. Kaplan-Meier survival curves and Fine and Gray subdistribution hazard models, adjusted for age, diabetes, dialysis vintage, Kt/V, glucose, calcium, blood flow, and pre-HD cardiovascular disease, were used to assess thrombosis risk.
Results. Of 562 patients (median follow-up 59 months), 212 (37.7%) were statin users. AVF thrombosis occurred in 54 (9.6%) patients, with 11 (7.1%) in statin users vs. 43 (10.6%) in non-users (p = 0.006). Kaplan-Meier analysis showed lower thrombosis probability in statin users (log-rank p = 0.001), with high-intensity users having the lowest risk (p = 0.004). In the unadjusted Fine and Gray model, high-intensity statins were associated with reduced thrombosis risk (sHR 0.61, 95% CI 0.59–0.97, p = 0.03), with a significant dose-dependent trend (p = 0.018). The adjusted model showed no significant association (moderate: sHR 0.67, p = 0.16; high: sHR 0.57, p = 0.26).
Conclusions. Statin use, particularly high-intensity, may reduce AVF thrombosis risk in HD patients, with a dose-dependent trend in unadjusted analyses. However, adjusted results were non-significant, possibly due to limited events. Larger prospective studies are needed to confirm these findings and optimize statin therapy for vascular access preservation.
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| format | Article |
| id | doaj-art-ecb78741a231420f84ee6cfb141bf460 |
| institution | DOAJ |
| issn | 2304-0238 2616-7352 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | National Kidney Foundation of Ukraine |
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| series | Український Журнал Нефрології та Діалізу |
| spelling | doaj-art-ecb78741a231420f84ee6cfb141bf4602025-08-20T02:39:54ZengNational Kidney Foundation of UkraineУкраїнський Журнал Нефрології та Діалізу2304-02382616-73522025-04-012(86)10.31450/ukrjnd.2(86).2025.03Retrospective analysis of statin use and arteriovenous fistula thrombosis in hemodialysis: Is there a dose-dependent effect?Natalia Stepanova0Tetyana Ostapenko1Valeriia Marchenko2Alina Holovanova3Mariia Lysii4Tetyana Kucher5Viacheslav Filonov6Victor Dzhur7Bohdan Stetsenko8Hanna Moroid9Nataliia Pavchak10Kateryna Rusyn11Oksana Rusyn12Bohdan Radiuk13State Institution “O.O. Shalimov National Scientific Center of Surgery and Transplantology of the National Academy of Medical Science of Ukraine,” Kyiv, Ukraine; Medical Center “Nephrocenter,” Kyiv, Ukraine Medical Center “Nephrocenter,” Zaporizhzhia, UkraineMedical Center “Nephrocenter,” Zaporizhzhia, UkraineMedical Center “Nephrocenter,” Zaporizhzhia, UkraineMedical Center “Nephrocenter,” Stryi, UkraineMedical Center “Nephrocenter,” Sarny, UkraineMedical Center “Nephrocenter,” Odesa, UkraineMedical Center “Nephrocenter,” Kyiv, UkraineMedical Center “Nephrocenter,” Kyiv, UkraineMedical Center “Nephrocenter,” Sheptytskyi, UkraineMedical Center “Nephrocenter,” Drohobych, UkraineMedical Center “Nephrocenter,” Lviv, UkraineMedical Center “Nephrocenter,” Lviv, UkraineMedical Center “Nephrocenter,” Gorodok, Ukraine Arteriovenous fistula (AVF) thrombosis is a major vascular access complication in hemodialysis (HD) patients, contributing to increased morbidity. Statins, known for their pleiotropic effects, may reduce AVF thrombosis risk, but evidence on dose-dependent effects is limited. This study evaluated the association between statin use, dose intensity, and AVF thrombosis in HD patients. Methods. A multicenter, retrospective cohort study was conducted using data from 562 HD patients with native AVFs across 10 dialysis clinics (May 2021–April 2025). Patients were categorized by statin use (users vs. non-users) and dose intensity (moderate vs. high vs. none). The primary outcome was AVF thrombosis; death was treated as a competing event. Kaplan-Meier survival curves and Fine and Gray subdistribution hazard models, adjusted for age, diabetes, dialysis vintage, Kt/V, glucose, calcium, blood flow, and pre-HD cardiovascular disease, were used to assess thrombosis risk. Results. Of 562 patients (median follow-up 59 months), 212 (37.7%) were statin users. AVF thrombosis occurred in 54 (9.6%) patients, with 11 (7.1%) in statin users vs. 43 (10.6%) in non-users (p = 0.006). Kaplan-Meier analysis showed lower thrombosis probability in statin users (log-rank p = 0.001), with high-intensity users having the lowest risk (p = 0.004). In the unadjusted Fine and Gray model, high-intensity statins were associated with reduced thrombosis risk (sHR 0.61, 95% CI 0.59–0.97, p = 0.03), with a significant dose-dependent trend (p = 0.018). The adjusted model showed no significant association (moderate: sHR 0.67, p = 0.16; high: sHR 0.57, p = 0.26). Conclusions. Statin use, particularly high-intensity, may reduce AVF thrombosis risk in HD patients, with a dose-dependent trend in unadjusted analyses. However, adjusted results were non-significant, possibly due to limited events. Larger prospective studies are needed to confirm these findings and optimize statin therapy for vascular access preservation. https://ukrjnd.com.ua/index.php/journal/article/view/952hemodialysis, arteriovenous fistula, thrombosis, statins, risk, treatment. |
| spellingShingle | Natalia Stepanova Tetyana Ostapenko Valeriia Marchenko Alina Holovanova Mariia Lysii Tetyana Kucher Viacheslav Filonov Victor Dzhur Bohdan Stetsenko Hanna Moroid Nataliia Pavchak Kateryna Rusyn Oksana Rusyn Bohdan Radiuk Retrospective analysis of statin use and arteriovenous fistula thrombosis in hemodialysis: Is there a dose-dependent effect? Український Журнал Нефрології та Діалізу hemodialysis, arteriovenous fistula, thrombosis, statins, risk, treatment. |
| title | Retrospective analysis of statin use and arteriovenous fistula thrombosis in hemodialysis: Is there a dose-dependent effect? |
| title_full | Retrospective analysis of statin use and arteriovenous fistula thrombosis in hemodialysis: Is there a dose-dependent effect? |
| title_fullStr | Retrospective analysis of statin use and arteriovenous fistula thrombosis in hemodialysis: Is there a dose-dependent effect? |
| title_full_unstemmed | Retrospective analysis of statin use and arteriovenous fistula thrombosis in hemodialysis: Is there a dose-dependent effect? |
| title_short | Retrospective analysis of statin use and arteriovenous fistula thrombosis in hemodialysis: Is there a dose-dependent effect? |
| title_sort | retrospective analysis of statin use and arteriovenous fistula thrombosis in hemodialysis is there a dose dependent effect |
| topic | hemodialysis, arteriovenous fistula, thrombosis, statins, risk, treatment. |
| url | https://ukrjnd.com.ua/index.php/journal/article/view/952 |
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