Relationship between plasma Gas6 level and arteriovenous fistula thrombosis in maintenance hemodialysis patients

Objective To detect the expression of growth arrest-specific protein 6(Gas6) in the plasma of maintenance hemodialysis(MHD) patients and explore the correlation between Gas6 and arteriovenous fistula thrombosis. Methods From October 2017 to November 2019, 165 MHD patients undergoing autologous arteriovenous fistula surgery were selected as observation subjects(MHD group), including 108 thrombosis patients without arteriovenous fistula(thrombosis without internal arteriovenous fistula group) and 57 thrombosis patients with arteriovenous fistula(thrombosis with internal arteriovenous fistula group);another 150 cases of healthy physical examination during the same period were selected as control group. Histories of diabetes mellitus and hypertension and blood biochemical parameters were recorded. Enzyme-linked immunosorbent assay was utilized for measuring the plasma Gas6 level, receiver operating curve(ROC) curve for detecting the diagnostic value of plasma Gas6 for arteriovenous fistula thrombosis and Logistic regression for examining the influencing factors of arteriovenous fistula thrombosis. Results The plasma Gas6 level was significantly higher in MHD group than that in control group(P<0.05);Compared with thrombosis without internal arteriovenous fistula group, proportion of diabetics, proportion of patients with unfractionated heparin, low-density lipoprotein(LDL), C-reactive protein(CRP), D-dimer, platelets(PLT), fibrinogen(FIB), hemoglobin(Hb), blood phosphorus and plasma Gas6 level were significantly elevated in arteriovenous fistula thrombosis group. Systolic and diastolic blood pressures dropped obviously(P<0.05);ROC curve analysis showed that the sensitivity of plasma Gas6 was 85.96% for predicting arteriovenous fistula thrombosis. The specificity was 82.41% with a cut-off value of 18.33 μg/L and area under the curve of 0.860. Logistic regression analysis indicated that diabetes mellitus, LDL, D-dimer, ultrafiltration volume and Gas6 were risk factors for arteriovenous fistula thrombosis in MHD patients(P<0.05). Conclusion With a high plasma level in MHD patients with arteriovenous fistula thrombosis, Gas6 may become a potential marker for predicting arteriovenous fistula thrombosis in MHD patients.