Abstract: Objective  To investigate the relationship between serum levels of residual lipoprotein cholesterol (RLP-C), nuclear factor kappa B (NF-κB), and stromal interaction molecule 1 (STIM1) and arteriovenous fistula (AVF) thrombosis in maintenance hemodialysis (MHD) patients.  Methods  A total of 209 MHD patients undergoing autologous AVF surgery at our Hospital was selected. During the 12-month follow-up study, 71 patients developed thrombosis and 138 did not. In addition, 243 healthy individuals were recruited  as the control group. Serum samples were collected to measure serum levels of RLP-C, NF-κB, and STIM1.  Results  Serum levels of RLP-C, NF-κB, STIM1, C-reactive protein (CRP), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α) were higher in the MHD patients than in the control group (t=35.664, 54.133, 34.955, 59.703, 97.831 and 32.253 respectively; all P＜0.001). The thrombosis group exhibited higher levels of all aforementioned indicators and low-density lipoprotein cholesterol (LDL-C) compared to the non-thrombosis group (t=7.848, 8.662, 7.761, 9.161, 12.541, 6.076 and 59.703 respectively; all P＜0.001). LDL-C (OR=4.725, 95% CI: 2.640～8.457, P＜0.001), IL-6 (OR=3.782, 95% CI: 1.491～9.595, P=0.005), and CRP (OR=5.019, 95% CI: 1.083～3.766, P=0.027), TNF-α (OR=4.396, 95% CI: 2.741～7.050, P＜0.001), RLP-C (OR=5.627, 95% CI: 3.586～5.970, P＜0.001), NF-κB (OR=6.250, 95% CI: 4.281～9.124, P＜0.001), and STIM1 (OR=6.468, 95% CI: 3.356～8.908, P＜0.001) were identified as the risk factors for AVF thrombosis. Serum RLP-C, NF-κB, and STIM1 were positively correlated with IL-6 (r=0.533, 0.614 and 0.504; P＜0.001), CRP (r=0.714, 0.568 and 0.672; P＜0.001) and TNF-α (r=0.635, 0.527 and 0.493; P＜0.001). The area under the curve of combined use of RLP-C, NF-κB and  STIM1 was superior to that of individual use of RLP-C (Z=2.630, P=0.009), NF-κB (Z=2.539, P=0.011), and STIM1 (Z=3.013, P=0.003) for the prediction of AVF thrombosis.  Conclusion Serum RLP-C, NF-κB and STIM1 in MHD patients correlate with micro-inflammatory state and AVF thrombosis. Combined use of serum RLP-C, NF-κB and STIM1 may predict the risk  of AVF thrombosis in MD patients.

Key words: Arteriovenous fistula, Thrombosis, Residual lipoprotein-cholesterol, Nuclear factor kappa B, Stromal interaction molecule 1