ANTICARDIOLIPIN ANTIBODY IN PATIENTS ON MAINTENANCE HEMODIALYSIS AND ITS ASSOCIATION WITH RECURRENT ARTERIOVENOUS GRAFT THROMBOSIS

To investigate the relationship between dialysis access thrombosis (arteriovenous grafts [AVG] and arteriovenous fistulas [AVF]) and the presence of elevated concentration of immunoglobulin G-anticardiolipin antibody (IgG-ACA), we conducted a cross-sectional study of all patients, in a single dialysis facility, who had a minimum of 6 months of uninterrupted hemodialysis, Episodes of thrombosis of AVGs and AVFs in the preceding 30 months were documented and each patient's IgG-ACA titer was determined, Sixteen of 74 patients with AVGs (22%) had a raised titer of IgG-ACA compared with only one of 17 patients (6%) with AVFs, In the patients with AVGs the odds ratio for patients with raised IgG-ACA titer to have experienced two or more episodes of thrombosis, compared with none or only one episode, was 3.7 (95% confidence interval, 1.2 to 11.8; P < 0.04). No events of AVF thrombosis were encountered during the same period, We conclude that in end-stage renal disease patients undergoing hemodialysis, there is a greater prevalence of elevated IgG-ACA titer in patients with AVGs than in patients with AVFs, and this in turn is associated with increased odds of having had recurrent AVG thrombosis. (C) 1995 by the National Kidney Foundation, Inc.