Abstract: 【Abstract】Objective To evaluate the relationship between cardiac valve calcification (CVC) and failure of arteriovenous fistula (AVF) in patients with maintenance hemodialysis (MHD). Methods A total of 95 MHD patients treated at Beijing Haidian Hospital from June 2019 to December 2020 were recruited. Their clinical data and laboratory results were collected. The extent of CVC by color Doppler ultrasonography was classified into four (none, slight, medium, heavy) grades. Patients were then divided into minor CVC group (patients with none or slight CVC) and severe CVC group (patients with medium or heavy CVC). The association
between CVC severity, clinical factors, and failure of AVF was then analyzed by Cox proportional hazard analysis. Results The severity of CVC increased along with the increase of age (t=2.463, P<0.016). Serum phosphate (t=- 4.075, P<0.001) and parathyroid hormone (t=- 3.398, P<0.001) were higher and prealbumin (t= -2.412, P=0.018) was lower in severe CVC group as compared with those in minor CVC group. Multivariate regression analysis showed that severe CVC was the independent risk factor for failure of AVF, and the risk for failure of AVF in severe CVC patients was 4.909 times higher than that in minor CVC patients (OR=4.909, 95% CI：1.972～12.222, P=0.001). Conclusions Older age, higher serum phosphate, parathyroid hormone and TG, and lower serum prealbumin were the risk factors for CVC. Severe CVC can be used to predict the failure of AVF in MHD patients.

Key words: Maintenance hemodialysis, Cardiac valve calcification, Failure of arteriovenous fistula, Relationship