Abstract: Objective  To investigate the correlation of atherogenic index of plasma (AIP) and non-high-density lipoprotein cholesterol (non-HDL-C) with the vascular access failure (VAF) in hemodialysis patients, and to evaluate the prediction value of AIP and non-HDL-C for VAF risks.  Methods  A total of 277 patients on maintenance hemodialysis (MHD) with autologous arteriovenous fistula (AVF) treated in the Dialysis Center of Beijing Chaoyang Hospital from January 2017 to December 2021 were recruited. They were divided into VAF group (n=85) and non-VAF group (n=192). AIP, non-HDL-C and clinical characteristics were compared between the two groups. Multivariate COX regression was used to analyze the independent factors for VAF risks. ROC curve was drawn to evaluate the prediction value for VAF risks by AIP and non-HDL-C in MHD patients.  Results  AIP (Z=7.331, P<0.001) and non-HDL-C (Z=6.566, P<0.001) were statistically higher in the VAF group than in the non-VAF group. After adjustment for sex, age, blood creatinine and uric acid, AIP (HR=8.757; 95% CI: 4.134, 18.548; P< 0.001) and non-HDL-C (HR=1.533; 95% CI:1.094, 2.150; P<0.001) remained the independent factors for VAF risks. AUC of the prediction for VAF risks by AIP was 0.776 (95% CI:0.722, 0.831), by non-HDL-C was 0.747 (95% CI:0.690, 0.805), and by combined both was 0.805 (95% CI:0.690, 0.805).  Conclusions  AIP and non-HDL-C are the independent factors for VAF risks. AIP, non-HDL-C or combination of the two have a good predictive value for VAF risks.

Key words: Vascular access failure, Hemodialysis, Atherogenic index of plasma, Non-high density lipoprotein cholesterol