Matrix‐Metalloproteinase‐2 Predicts Arteriovenous Fistula Failure in Hemodialysis Patients

In hemodialysis patients the principal cause of arteriovenous fistula dysfunction is stenosis. Matrix‐metalloproteinase‐2 is implicated in the pathophysiological mechanism of stenosis development. Our study tried to assess the clinical impact of this protease on arteriovenous fistula survival. Seventy‐nine prevalent dialysis patients with functional arteriovenous fistulas were included in the study. The presence of stenosis and the serum levels of matrix‐metalloproteinase‐2 were determined at the beginning of the study. The patency of the arteriovenous fistulas was followed‐ up for two years. In multivariate regression; matrix‐metalloproteinase‐2 was a significant predictor of vascular access loss (HR = 1.104, 95%CI 1.033–1.179, P = 0.003). Patients with a level of matrix‐metalloproteinase‐2 lower than 50 ng/mL had a better survival of the arteriovenous fistulas. Matrix‐metalloproteinase‐2 was an even stronger predictor of fistula failure in the stenosis group (HR = 1.076, 95%CI 1.027–1.127, P = 0.002). In our study matrix‐metalloproteinase‐2 has a predictive value for arteriovenous fistula failure.