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Abstract
Patients with systemic lupus erythematosus (SLE) have a higher risk of vascular complications. This retrospective cohort study aimed to analyze the differences in the risk of arteriovenous fistula or graft (AVF/AVG) dysfunction in hemodialysis patients with and without SLE from Taiwan’s National Health Insurance Database over a 10-year period. AVF/AVG dysfunction is defined as the occurrence of the first episode of intervention after vascular access creation. A total of 1366 HD patients with SLE had higher incidence rates of AVF/AVG dysfunction than 4098 non-SLE HD patients in the following 4 periods: (1) after 1 year (incidence rates = 15.21% and 13.01%, respectively; subdistribution hazard ratio (SHR) = 1.16; P = 0.007), (2) 1st-to-10th-year period (15.36% and 13.25%; SHR = 1.16; P = 0.007), (3) 5th-to-10th-year period (11.91% and 8.1%; SHR = 1.42; P = 0.003), and (4) overall period (23.53% and 21.66%; SHR = 1.09; P = 0.027). In conclusion, there were significantly higher incidence rates of AVF/AVG dysfunction in SLE patients during the long-term follow-up period. Vascular access function should be monitored regularly by clinical examinations, especially after 1 year and during 5 to 10 years, to improve AVF/AVG patency and dialysis adequacy in SLE patients undergoing maintenance hemodialysis.
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1 National Yang Ming Chiao Tung University, School of Medicine, Hsinchu, Taiwan (GRID:grid.260539.b) (ISNI:0000 0001 2059 7017); National Yang-Ming University, School of Medicine, Taipei, Taiwan (GRID:grid.260770.4) (ISNI:0000 0001 0425 5914); Taipei Veterans General Hospital, Division of Nephrology, Department of Medicine, Taipei, Taiwan (GRID:grid.278247.c) (ISNI:0000 0004 0604 5314)
2 National Yang Ming Chiao Tung University, School of Medicine, Hsinchu, Taiwan (GRID:grid.260539.b) (ISNI:0000 0001 2059 7017); National Yang-Ming University, School of Medicine, Taipei, Taiwan (GRID:grid.260770.4) (ISNI:0000 0001 0425 5914); National Yang Ming Chiao Tung University Hospital, Division of Nephrology, Department of Internal Medicine, Yilan, Taiwan (GRID:grid.260770.4)
3 Taipei Veterans General Hospital, Division of Nephrology, Department of Medicine, Taipei, Taiwan (GRID:grid.278247.c) (ISNI:0000 0004 0604 5314)
4 National Yang Ming Chiao Tung University, School of Medicine, Hsinchu, Taiwan (GRID:grid.260539.b) (ISNI:0000 0001 2059 7017); National Yang-Ming University, School of Medicine, Taipei, Taiwan (GRID:grid.260770.4) (ISNI:0000 0001 0425 5914); Taipei City Hospital Zhongxing Branch, Division of Nephrology, Department of Medicine, Taipei, Taiwan (GRID:grid.410769.d) (ISNI:0000 0004 0572 8156); National Yang Ming Chiao Tung University, Institute of Food Safety and Health Risk Assessment, Hsinchu, Taiwan (GRID:grid.260539.b) (ISNI:0000 0001 2059 7017); National Yang-Ming University, Institute of Food Safety and Health Risk Assessment, Taipei, Taiwan (GRID:grid.260770.4) (ISNI:0000 0001 0425 5914); Fu Jen Catholic University, College of Science and Engineering, New Taipei City, Taiwan (GRID:grid.256105.5) (ISNI:0000 0004 1937 1063); University of Taipei, Taipei, Taiwan (GRID:grid.419832.5) (ISNI:0000 0001 2167 1370)
5 National Yang Ming Chiao Tung University, School of Medicine, Hsinchu, Taiwan (GRID:grid.260539.b) (ISNI:0000 0001 2059 7017); National Yang-Ming University, School of Medicine, Taipei, Taiwan (GRID:grid.260770.4) (ISNI:0000 0001 0425 5914); Taipei Veterans General Hospital, Division of Nephrology, Department of Medicine, Fenglin Branch, Hualien, Taiwan (GRID:grid.278247.c) (ISNI:0000 0004 0604 5314)
6 National Yang Ming Chiao Tung University, School of Medicine, Hsinchu, Taiwan (GRID:grid.260539.b) (ISNI:0000 0001 2059 7017); National Yang-Ming University, School of Medicine, Taipei, Taiwan (GRID:grid.260770.4) (ISNI:0000 0001 0425 5914); University of Taipei, Taipei, Taiwan (GRID:grid.419832.5) (ISNI:0000 0001 2167 1370); Taipei City Hospital Heping, Division of Nephrology, Department of Internal Medicine, Fuyou Branch, Taipei, Taiwan (GRID:grid.410769.d) (ISNI:0000 0004 0572 8156)