Abstract: Objective To explore the predictive value of fibrinogen to albumin ratio (FAR) for restenosis after percutaneous transluminal angioplasty (PTA) of the autologous arteriovenous fistula (AVF) in maintenance hemodialysis (MHD) patients.  Methods A total of 101 MHD patients undergoing color Doppler ultrasound-guided PTA for the first time at the Department of Nephrology, the Affiliated Hospital of Guilin Medical University from January 2019 to December 2020 were included in this study. According to the presence or absence of restenosis after PTA in the follow-up period, they were divided into restenosis group and patency group. Clinical data were compared between the two groups. Receiver operating characteristic (ROC) curve was made to evaluate the predictive value of FAR for restenosis after PTA. The optimal cut-off value of FAR was determined by ROC curve analysis. The patients were then divided into low FAR group and high FAR group. Patency rate of the AVF in the two groups was analyzed by Kaplan-Meier curve. Cox proportional hazards regression model was used to explore the independent risk factors affecting restenosis after PTA.  Results  ①Multivariate Cox regression analysis showed that higher FAR (HR=2.455, 95% CI:1.299～4.639, P=0.006) was an independent risk factor for restenosis of the AVF after first PTA. ② The area under the curve (AUC) of FAR for predicting restenosis of the AVF after PTA was 0.735 (P<0.001, 95% CI:0.638～0.818). ③ Kaplan-Meier curve survival analysis showed that the patency rate after PTA was significantly lower in high FAR group than in low FAR group (log rank test, χ²=15.470, P<0.001).  Conclusions   ①Higher FAR is an independent risk factor for restenosis after PTA. ②FAR can be used as a biomarker to predict restenosis after the first PTA, useful for early prevention and treatment of restenosis after PTA.

Key words: Percutaneous transluminal angioplasty, Restenosis, Fibrinogen to albumin ratio