Abstract: Objective  To explore the relationship between abdominal aortic calcification (AAC) and poor maturation of autologous arteriovenous fistula (AVF), and the influencing factors for poor maturation of AVF.  Methods  Patients with chronic kidney disease (CKD) at stage 5 and undergoing AVF construction for the first time at the First Affiliated Hospital of Xinxiang Medical university from October 2021 to October 2022 were enrolled in this study. Their general clinical data, hematological findings, AAC score, and preoperative and postoperative ultrasound examination results were collected. Patients were then divided into immature group and mature group according to physical examination, clinical use, and color Doppler ultrasound results after AVF surgery. Multivariate logistic regression was used to analyze the influencing factors for poor maturation of AVF.  Results  A total of 160 patients were included, with the age of 49.78±14.17 years old and 67.5% of males. There were statistically significant differences in age (t=4.078, P＜0.001), diabetes history (χ 2=4.050, P=0.044), AAC score (t=7.056, P＜0.001) and iPTH (t=2.151, P=0.035) between the two groups. Univariate logistic regression showed that age (OR=1.102, 95% CI 1.042～1.166, P=0.001), diabetes history (OR=2.807, 95% CI 1.010～7.803, P=0.048), AAC score (OR=1.559, 95% CI 1.269～1.915, P＜0.001) and iPTH (OR=1.002, 95% CI 1.000～1.005, P=0.040) were associated with poor maturation of AVF. Multivariate logistic regression showed that age (OR=1.073, 95% CI 1.007～1.142, P=0.030) and AAC score (OR=1.478, 95% CI 1.197～1.825, P＜0.001) were the independent influencing factors for poor maturation of AVF in CKD patients at stage 5.  Conclusions  Our study demonstrates that age and AAC score were the independent influencing factors for poor maturation of AVF. Therefore, age and AAC score should be considered in the evaluation of AVF maturation after operation.

Key words: Hemodialysis, Arteriovenous fistula, Maturation, Abdominal aorta, Vascular calcification