We prospectively measured anti-cardiolipin antibody (ACLA) levels in 230 ch
ronic hemodialysis (HD) patients over a 2-year period. Twenty-nine percent
of HD-patients were found to have elevated IgG-ACLA titers. Males were more
likely to have elevated IgG-ACLA titers. Elevated IgG-ACLA titers correlat
ed with shortened AVG survival in HD-patients (mean of 156 vs 238 days, p <
0.05). There was no statistically significant correlation with access surv
ival in AVF-patients. There seemed to be a higher mean IgG-ACLA titer in di
abetics but they did not have statistically significant shorter angioaccess
survival times. By logistic regression analysis, only IgG-ACLA positivity
was predictive of premature angioaccess failure (p < 0.05). In a selected s
ubset of 16 patients with frequent angioaccess (AVG) failure and elevated I
gG-ACLA levels, coumadin, titrated to an INR of 2-3, was found to produce a
small (though statistically significant) prolongation of AVG survival.