Abstract: Ｏｂｊｅｃｔｉｖｅ：A retrospective cohort study was conducted to explore influencing factors of primary patency rate of radiocephalic fistula (RCF) in patients with end stage kidney disease.
Ｍｅｔｈｏｄｏｌｏｇｙ：276 patients with  chronic kidney disease (CKD) stage 45 who underwent RCF creation for the first time in our hospital from January 2016 to June 2019 were enrolled. The followup time ended in November 2021, with a median followup of 40 months. Clinical data and biochemical parameters were collected. KaplanMeier survival curve was used to calculate the patency rate of RCF. RCF failure was defined as vascular stenosis (vessel diameter stenosis≥50％) or thrombosis, which could not provide sufficient blood flow to complete dialysis treatment. Multivariate Cox regression analysis was used to explore the related factors of RCF failure.
Ｒｅｓｕｌｔｓ：The mean age of the patients was 517±146 years, and 609％ were male. Chronic glomerulonephritis accounted for 446％ of CKD and diabetic nephropathy accounted for 311％. During followup, 68 (246％) patients developed fistula failure. KaplanMeier survival curve analysis showed that the primary patency rates at 12, 24, 36, 48 and 60 months after establishment of RCF were 895％, 830％, 783％, 757％ and 757％, respectively. Multivariate COX model analysis showed that age (≥65 years) was a risk factor for RCF failure, with HR value of 283 and 95％CI of 130~619. Adjusted calcium (per increase of 1mg／dL) was a protective factor for the RCF failure, with HR value of 066 and 95％CI of 047~094. However, gender, diabetes mellitus, hypertension, blood lipids, blood phosphorus and parathyroid hormone were not associated with RCF failure.
Ｃｏｎｃｌｕｓｉｏｎ：In this study, it was found that the primary patency rates of RCF creation were 895％ and 830％ at 12 and 24 months, respectively. The patency rate began to decline slowly over time. Age and corrected calcium level were significantly related to RCF failure.

Key words: end stage kidney disease, radio-cephalic fistula, primary patency, retrospective cohort study