Uncovering Candidate Genes Associated with Cardiovascular Disease in Patients with Arteriovenous Fistula and End-Stage Renal Disease.

Background: The molecular association between end-stage renal disease (ESRD), arteriovenous fistula (AVF) failure, and cardiovascular disease (CVD) remains unclear. This study aimed to investigate their potential relationship.

Methods: Three datasets were downloaded from the public database. AVF-failure-related differentially expressed genes (DEGs), CVD-related DEGs, and ESRD-related DEGs were identified by differential expression analysis and weighted gene co-expression network analysis. Then, AVF-failure-related, CVD-related, and ESRD-related DEGs were overlapped to obtain the hub genes. The diagnostic values of hub genes were evaluated. Finally, the immune infiltration analysis and drug prediction were performed.

Results: A total of four hub genes (ABCC8, ALPI, FGF11, and OBP2A) were identified, and those genes have excellent diagnostic accuracy. Among them, ABCC8, ALPI, and FGF11 showed good sensitivity and specificity. However, compared to the nondiabetic subgroup, the diagnostic ability of these genes was weaker in the diabetic subgroup for distinguishing AVF failure in ESRD patients. Type 17 T helper cells and gamma delta T cells may be associated with CVD caused by ESRD and AVF. A total of 15 drugs associated with hub genes were predicted.

Conclusion: ABCC8, ALPI, and FGF11 could serve as potential diagnostic biomarkers for AVF failure and CVD in HD-treated ESRD patients. Their robustness needs to be validated in larger cohorts and additional subgroups with comorbidities.