Valeri A, Radhakrishnan J
Anti-cardiolipin antibody in hemodialysis patients: a
prospective study
Am Soc Nephrol
J Am Soc Nephrol (abstract)
(Sep) 7:1423 1996
Antiphospholipid antibodies promote thrombosis in patients with or without
SLE. The presence of these antibodies in hemodialysis patients could
correlate with shorter arteriovenous (AV) graft survival.
The authors studied 230 chronic hemodialysis patients with AV fistulas or
AV grafts (2.6% with SLE) and found 26% with IgG-Anticardiolipin
antibodies (ACLA), 4% with IgM-ACLA and 3% with both types. AV graft
survival was 156 days in patients with AV grafts with either
antibody vs, 238 days in patients without such antibodies (p<0.05). No
statistical difference was seen in patients with
AV fistulas. Coumadin therapy in 11 patients (INR to 2) increased AVG
survival (49 to 63 days, p<0.05).
Comment: This study builds upon a growing body of evidence
correlating AV graft survival with presence of ACLA. Unanswered questions
include whether coumadin can prolong AV graft survival and what INR goal is
needed.
(Harold Bregman, M.D., Lutheran General Hospital, Park Ridge, IL)
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Am Soc Nephrol
Basic hemodialysis :
Vascular Access: graft/fistula