Abstract: Objective  To investigate the relationship between controlling nutritional status (CONUT) and late arteriovenous fistula (AVF) failure in patients with end-stage renal disease (ESRD).  Methods  The ESRD patients admitted to the Department of Nephrology, Beijing Ditan Hospital Affiliated to Capital Medical University from March 2021 to May 2022 were included in this study. They were divided into normal group, mild group, and moderate and severe group according to the preoperative CONUT score. Baseline data and laboratory indexes before AVF surgery were recorded. The late AVF failure was recorded during the follow-up period of 6 months after the surgery. The effect of CONUT on late AVF failure was analyzed.  Results  A total of 100 patients were enrolled in this study, including 28 cases in the normal group, 50 cases in the mild group and 22 cases in the moderate and severe group. Levels of lymphocyte count (Lym), albumin (ALB), total cholesterol (TC), uric acid (UA) and C-reactive protein (CRP) were different among the three groups (F=7331.645, 82.823, 27.704, 14.530 and 6.128 respectively; P<0.001). The rate of late AVF failure was 31.00 % in the follow-up period of 6 months. The rate of late AVF failure was statistically different among the three groups of patients (χ2=13.363, P=0.001), with higher in moderate and severe group than in normal group (χ2=13.732, P<0.001) and higher in mild group than in normal group (χ2=7.026, P=0.008), but without statistical significance between mild group and moderate to severe group (χ2=2.681, P=0.102). Logistic regression showed that malnutrition (mild: OR=10.321, 95% CI 1.297～81.978, P=0.027; moderate and severe: OR=18.559, 95% CI 1.484～232.091,P=0.023) was a risk factor for late AVF failure in ESRD patients.  Conclusion The late AVF failure in ESRD patients on hemodialysis is related to moderate and severe malnutrition. CONUT scoring is helpful for the screening of the ESRD patients with risk of late AVF failure.

Key words: End-stage renal disease, Late failure of arteriovenous fistula, Controlling nutritional status