{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T01:53:59Z","timestamp":1791251639192,"version":"4.1.0"},"reference-count":19,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,5,24]],"date-time":"2026-05-24T00:00:00Z","timestamp":1779580800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,5,24]],"date-time":"2026-05-24T00:00:00Z","timestamp":1779580800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Hemodialysis International"],"published-print":{"date-parts":[[2026,10]]},"abstract":"ABSTRACT<\/jats:title>\n \n Background<\/jats:title>\n Failure of autogenous arteriovenous fistulas (AV fistulas) due to venous neointimal hyperplasia is a major clinical challenge. Whether the rate of progression in venous intima\u2010media thickness predicts primary unassisted patency failure remains unknown.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n In this prospective cohort study, we performed a 6\u2010month landmark analysis to minimize immortal time bias among patients with newly created AV fistulas. Intima\u2010media thickness was measured serially by ultrasound. We calculated the early progression rate (0\u20136\u2009months) as the primary predictor and the 0\u201312\u2009month rate as a sensitivity analysis. Cox proportional hazards models were used to assess the association between the early progression rate and subsequent primary unassisted patency failure.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n The analysis included 129 patients who were event\u2010free at the 6\u2010month landmark. Over a median follow\u2010up of 13.2\u2009months after the landmark, 35 patients (27.1%) experienced primary unassisted patency failure. Faster early intima\u2010media thickness progression was a strong independent predictor of failure (adjusted hazard ratio [HR] 1.63 per 0.05\u2009mm\/year increase; 95% CI 1.41\u20131.88;\n p<\/jats:italic>\n \u2009<\u20090.001), together with baseline intima\u2010media thickness and diabetes. Adding the early progression rate to a model containing clinical and baseline ultrasound variables significantly improved discrimination (C\u2010index increased from 0.69 to 0.76,\n p<\/jats:italic>\n \u2009=\u20090.002) and risk reclassification (net reclassification improvement\u2009=\u20090.21,\n p<\/jats:italic>\n \u2009=\u20090.008).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Early venous intima\u2010media thickness progression rate is a powerful independent predictor of subsequent AV fistula failure and adds substantial prognostic value beyond standard clinical and ultrasound factors. Serial ultrasound monitoring of this parameter may support the development of risk\u2010adapted surveillance strategies to prolong AV fistula survival.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/hdi.70084","type":"journal-article","created":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T03:23:42Z","timestamp":1779679422000},"page":"730-738","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Intima\u2010Media Thickness Progression Rate and Primary Unassisted Patency Failure in Arteriovenous Fistulas: A Prospective Cohort Study"],"prefix":"10.1111","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-3734-5657","authenticated-orcid":false,"given":"Gen","family":"Li","sequence":"first","affiliation":[{"name":"Department of Nephrology West China TianFu Hospital of Sichuan University Chengdu Sichuan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhengjiang","family":"Cao","sequence":"additional","affiliation":[{"name":"Department of Nephrology West China TianFu Hospital of Sichuan University Chengdu Sichuan China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,24]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1681\/asn.2005050615"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0324004"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.3389\/fcvm.2022.984472"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2019.12.001"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2024.01.001"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1523\u20101755.2002.kid551.x"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1159\/000092129"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/sdi.12162"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.11102439"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1525\u2010139X.2012.01112.x"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.0006\u2010341x.2000.00337.x"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/sim.2929"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1161\/circulationaha.124.072525"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.2215\/cjn.00490119"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1152\/physrev.00047.2009"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/jcp.31200"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1161\/circulationaha.106.628875"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1159\/000343145"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1159\/000081812"}],"container-title":["Hemodialysis International"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/hdi.70084","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/hdi.70084","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/hdi.70084","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T01:46:37Z","timestamp":1791251197000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/hdi.70084"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,24]]},"references-count":19,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026,10]]}},"alternative-id":["10.1111\/hdi.70084"],"URL":"https:\/\/doi.org\/10.1111\/hdi.70084","archive":["Portico"],"relation":{},"ISSN":["1492-7535","1542-4758"],"issn-type":[{"value":"1492-7535","type":"print"},{"value":"1542-4758","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,24]]},"assertion":[{"value":"2025-12-09","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-30","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-24","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}