Elevated Trimethylamine-N-oxide (TMAO) Is Associated with Vascular Access Dysfunction in Maintenance Hemodialysis Patients.

Abstract

Introduction: Elevated levels of trimethylamine-N-oxide (TMAO), a metabolite produced by gut microbiota, have been associated with cardiovascular diseases and complications in various populations. However, its role in vascular access dysfunction in hemodialysis patients remains underexplored. This study investigates the potential relationship between TMAO levels and vascular access dysfunction in maintenance hemodialysis patients.

Methods: This study included 80 hemodialysis patients. The baseline serum TMAO levels were measured, and clinical characteristics and dialysis-related data were collected. They were followed up on vascular access dysfunction events over a period of 1 year. The association between serum TMAO levels and vascular access dysfunction events were investigated.

Findings: In our cohort, we observed a wide distribution of serum concentrations, with a median concentration of 15.2 μmol/L and a maximum concentration of 245.3 μmol/L. Patients were stratified into a low-TMAO group and a high-TMAO group according to the median value of TMAO concentrations. Those in the high-TMAO group had a significantly higher incidence of vascular access dysfunction events (p = 0.023). TMAO was independently associated with vascular access dysfunction events after adjusting for some potential vascular access dysfunction risk factors.

Discussion: This study suggests that elevated serum TMAO levels may serve as an independent risk factor for vascular access dysfunction in hemodialysis patients. Reducing TMAO levels may potentially decrease the incidence of vascular access dysfunction, warranting further investigation into this therapeutic approach.