Features of Central Hemodynamics in Patients With Vascular Access Thrombosis on Maintenance Hemodialysis

Q: What are the key findings of this study?

Vascular access thrombosis in hemodialysis patients was significantly associated with higher 24-hour systolic blood pressure variability (22.10 vs 16.43 mmHg) and pronounced right ventricular dilation compared to those without thrombosis.

Q: What is the clinical evidence from this study?

Study design: Case-Control. Population: Stage 5 Chronic Kidney Disease (n=90). Intervention: Vascular access thrombosis vs. No vascular access thrombosis. Primary outcome: Systolic blood pressure variability (SBPV) over 24 hours (p=<0.001).

Q: What does this research mean for the field?

Vascular access thrombosis in hemodialysis patients is significantly associated with higher systolic blood pressure variability, frequent intradialytic hypotension, and pronounced cardiac remodeling including right ventricular dilation. Novelty: ClaimNovelty.CONFIRMATORY. Consensus alignment: ConsensusAlignment.SUPPORTS_CONSENSUS.

Q: What question did this study set out to answer?

To evaluate central hemodynamic characteristics and cardiovascular markers associated with the development of vascular access thrombosis in patients receiving maintenance hemodialysis.

E.A. Khatamov; B. T. Daminov

doi:10.70413/cajar-v04-i10-s59975

October 6, 2026Open Access

Features of Central Hemodynamics in Patients With Vascular Access Thrombosis on Maintenance Hemodialysis

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Key result

Vascular access thrombosis is linked to ~6 mmHg higher 24-hour systolic BP variability in hemodialysis.

P<0.001
n=90

Why the study?

Studying hemodynamic markers for the development of vascular access thrombosis in maintenance hemodialysis patients is highly relevant due to known risk factors and prognostic implications.

Key Points

To evaluate central hemodynamic characteristics and cardiovascular markers associated with the development of vascular access thrombosis in patients receiving maintenance hemodialysis.
Evaluated 90 patients receiving maintenance hemodialysis, comparing those with vascular access thrombosis (n=45) to those with uncomplicated vascular access (n=45).
Conducted 24-hour ambulatory blood pressure monitoring (ABPM) and echocardiography to analyze circadian blood pressure variability and structural heart changes.
Systolic blood pressure variability was significantly higher in patients with vascular access thrombosis than in those without thrombosis (22.10±4.58 mmHg vs. 16.43±4.01 mmHg, p<0.001).
Hypotensive episodes during hemodialysis (systolic BP <100 mmHg or diastolic BP <60 mmHg) occurred in 31 patients (68.89%) with thrombosis versus 16 patients (35.56%) without thrombosis (chi-square = 6.67, p<0.01).
Patients with thrombosis displayed significantly greater cardiac chamber remodeling and pulmonary pressures, including right ventricular diameter (35.93±4.27 mm vs. 30.60±4.81 mm, p<0.001) and systolic pulmonary artery pressure (41.63±7.73 mmHg vs. 31.97±7.52 mmHg, p<0.001).

Study Design

Type

Case-Control (n=90)

Multicenter

No

Structured PICO

P

Population

90 patients with stage 5 chronic kidney disease on maintenance hemodialysis via arteriovenous fistula for at least 1 year, comprising 45 patients with a history of vascular access thrombosis and 45 controls without thrombosis.

O

Outcome

Central hemodynamic parameters measured via echocardiography (LVEDD, LV end-systolic dimension, LA diameter, RV diameter, LVEF, sPAP, RAP) and 24-hour ambulatory blood pressure monitoring (mean SBP, mean DBP, diurnal index, SBP variability, DBP variability) assessed on the second day after hemodialysis.surrogate

Main Result

Absolute Event Rate: 22.1% vs 16.43%

p-value: p=<0.001

In patients on maintenance hemodialysis, increased systolic blood pressure variability, hypotensive episodes during dialysis, and pronounced right ventricular remodeling are significant hemodynamic markers associated with recurrent vascular access thrombosis.

Limitations

Retrospective study design
Small sample size
Single-center study

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Implication

May signal higher thrombosis risk in hemodialysis; hypothesis-generating for BP variability or RV-targeted prevention trials.

Abstract

Epidemiological research on vascular access insufficiency shows that the frequency of this complication increases with the age of patients, occurs more frequently in women than in men, and is more common in ethnic groups with higher incidence rates of diabetes mellitus and cardiovascular diseases [10,11]. Additionally, risk factors for vascular access insufficiency include an increased body mass index, background cardiovascular and peripheral vascular diseases, and diabetes mellitus. Another prognostically unfavorable situation is the need for HD before the maturation of the AV fistula (i.e., using other access options while the AV fistula matures) [14,15]. Based on these data, studying the hemodynamic markers for the development of vascular access thrombosis is highly relevant and formed the basis for this study.

Discussion

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Cite This Study

Khatamov et al. (2026) conducted a case-control in Stage 5 Chronic Kidney Disease (n=90). Vascular access thrombosis vs. No vascular access thrombosis was evaluated on Systolic blood pressure variability (SBPV) over 24 hours (p=<0.001). Vascular access thrombosis in hemodialysis patients was significantly associated with higher 24-hour systolic blood pressure variability (22.10 vs 16.43 mmHg) and pronounced right ventricular dilation compared to those without thrombosis.

synapsesocial.com/papers/6ad49f5fcc23993462cc5350 https://doi.org/10.70413/cajar-v04-i10-s59975

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Features of Central Hemodynamics in Patients With Vascular Access Thrombosis on Maintenance Hemodialysis

Key Points

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Features of Central Hemodynamics in Patients With Vascular Access Thrombosis on Maintenance Hemodialysis

Key Points

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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