Abstract: Objective  To investigate the relationship between serum soluble lectin-like oxidized low density lipoprotein receptor-1(sLOX-1) and complement C1q/tumor necrosis factor related protein 9 (CTRP9) levels and arteriovenous fistula (AVF) thrombosis in maintenance hemodialysis (MHD) patients.  Methods  From November 2022 to March 2024, a total of 124 patients who underwent hemodialysis in our hospital and developed thrombosis in AVF were recruited as the observation group. Moreover, a total of 120 patients who underwent hemodialysis in our hospital but did not develop AVF thrombosis were recruited as the control group. These patients had received MHD for more than 3 years at the time of investigation. Serum sLOX-1 and CTRP9 levels were determined by ELISA. Pearson correlation analysis was used for the correlation between serum sLOX-1 and CTRP9 levels and AVF thrombosis, logistic regression for the influencing factors for AVF thrombosis, and ROC curve for the efficacy of serum sLOX-1 and CTRP9 levels in predicting the occurrence of AVF thrombosis.  Results There were statistically significant differences between the observation group and the control group in mean arterial pressure (t=5.964, P＜0.001) and low-density lipoprotein cholesterol levels (t=20.356, P＜0.001). In the observation group, serum CTRP9 was lower (t=9.703, P＜0.001) and serum sLOX-1 was higher (t=9.747, P＜0.001) as compared those in the control group; serum CTRP9 level was negatively correlated with serum sLOX-1 level (r=-0.422, P＜0.001). Higher serum sLOX-1 level (OR=2.371, 95% CI: 1.386～4.057, P=0.002) was the independent risk factor for AVF thrombosis in patients, whereas higher serum CTRP9 level (OR=0.746, 95% CI: 0.570～0.976, P=0.032) was the independent protective factor against AVF thrombosis. The AUCs using serum sLOX-1, CTRP9 and combination of sLOX-1 and CTRP9 levels to predict the occurrence of AVF thrombosis were 0.832, 0.807 and 0.894 respectively, demonstrating that combination of the two levels is better than serum sLOX-1 or serum  CTRP9 for the prediction (sLOX-1–the combination: Z=2.021, P=0.043; CTRP9–the combination: Z=2.458, P=0.014).  Conclusion  Determination of serum sLOX-1 and CTRP9 levels can assess the risk of AVF thrombosis in MHD patients, and can also provide reference values for early intervention of AVF thrombosis in clinical practice.

Key words: Soluble lectin-like oxidized low density lipoprotein receptor-1, Complement C1q/tumor necrosis factor related protein 9, Maintenance hemodialysis, Arteriovenous fistula thrombosis