Abstract: Objective  To observe the relationship between aortic calcification and primary patency rate of autologous internal fistula in maintenance hemodialysis patients, and to explore the possibility of predicting the dysfunction of autologous internal fistula by aortic calcification score.  Methods  A total of 88 patients who underwent autologous arteriovenous fistula and hemodialysis for the first time in our hospital were selected. Their abdominal aortic calcification index (ACI) at the time of internal fistula surgery was recorded. According to the results of ACI, the patients were divided into high calcification group and low calcification group. The primary patency rate of autologous internal fistula within 3 years was observed in the two groups.  Results   Seventy patients (93.33%) had different degrees of aortic calcification, including 35 patients in the high calcification group (ACI ≥10%). During the 3-year follow-up period, a total of 31 patients developed various internal fistula dysfunctions, including thrombosis in 17 cases and internal fistula stenosis in 10 cases. After 12, 24 and 36 months, the primary patency rates of internal fistulas were 92.5%, 85% and 76.9% in low calcification group, and were 88.6%, 68.5% and 45.9% in high calcification group (χ2=7.182, P=0.007). COX regression showed that autologous internal fistula dysfunction was related to ACI (HR=5.788, 95% CI:1.488～22.514, P=0.011).  Conclusions  Higher ACI is related to the dysfunction of autologous arteriovenous fistula within 3 years. Internal fistula function dysfunction should be monitored and treated earlier in patients with higher ACI to prolong the survival of internal fistula.

Key words: Arteriovenous fistula, Aortic calcification, Primary patency rate