Abstract: Objective  To investigate the relationship and influencing factors between abdominal aortic calcification (AAC), radial artery calcification (RAC), and arteriovenous fistula (AVF) maturation in patients with end-stage renal disease (ESRD).  Methods  A total of 75 ESRD patients undergoing AVF surgery were enrolled in this study. Preoperative X-ray was used to assess the degree of AAC and RAC, and end-to-side anastomosis of radial artery to cephalic vein was performed for AVF construction, with intraoperative recording of arterial calcification. Based on the degree of AAC, patients were divided into a control group (n=44) and a calcification group (n=31). After the surgery, AVF maturation was evaluated and maturation time was recorded every month for 3 months.  Results  The AVF maturation rate was significantly higher in the control group than in the calcification group (84.1% vs. 58.1%, χ²=6.300, P=0.012), and the maturation time was significantly longer in the calcification group (69.33±26.502 days vs. 46.54±17.925 days, t=-3.300, P=0.003) than in the control group. Univariate analysis showed that gender (OR=13.180, 95% CI: 0.038～0.376, P＜0.001), age (OR=2.961, 95% CI: 0.995～1.086, P=0.085), cephalic vein dilatation (OR=4.766, 95% CI: 0.053～0.854, P=0.029), intraoperative RAC (OR=5.669, 95% CI: 1.258～10.629, P=0.017), and AAC (OR=3.817, 95% CI: 1.229～11.216, P=0.015) were the risk factors for delayed AVF maturation. Multivariate analysis revealed that female gender (OR=11.477, 95% CI: 0.024～0.370, P=0.001), cephalic vein dilatation (OR=4.664, 95% CI: 0.032～0.847, P=0.031), intraoperative RAC (OR=5.788, 95% CI: 1.362～20.618, P=0.016), and AAC (OR=0.149, 95% CI: 0.028～0.786, P=0.025) were the independent risk factors for delayed AVF maturation.  Conclusion  AAC, intraoperative RAC, poor cephalic vein dilatation and female are the independent risk factors for delayed AVF maturation.

Key words: Abdominal aortic calcification, Radial artery calcification, Arteriovenous fistula, Fistula maturation