{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T18:26:23Z","timestamp":1789064783466,"version":"build-2803163510"},"reference-count":46,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2026,1,16]],"date-time":"2026-01-16T00:00:00Z","timestamp":1768521600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Vasc Access"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:p>\n                    Arteriovenous Fistula (AVF) failure remains a significant challenge in patients on hemodialysis. No meta-analysis has concluded the relationship between fetuin-A serum levels, arterial calcification, and AVF failure. This study aims to evaluate the relationship between fetuin-A levels and AVF failure through vascular calcification in CKD patients undergoing hemodialysis. This meta-analysis was conducted according to the PRISMA guideline. On October 1st, 2024, a literature search was conducted in PubMed and ScienceDirect. Data were analyzed using Review Manager for pooled hazard ratio and standardized mean difference (SMD), while MedCalc software was used to calculate the pooled correlation coefficient. A total of 26 observational studies were included. Meta-analysis showed that fetuin-A levels were negatively correlated with vascular calcification (\n                    <jats:italic toggle=\"yes\">r<\/jats:italic>\n                    \u2009=\u2009\u22120.530; 95% CI: \u22120.781 to \u22120.132;\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009=\u20090.011). The mean fetuin-A levels were lower in the group with vascular calcification than those without calcification (SMD\u2009=\u2009\u22121.71; 95% CI: \u22122.58 to \u22120.85;\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009=\u20090.0001). Patients with vascular calcification had a 2.98 times higher risk of AVF failure (OR\u2009=\u20092.98; 95% CI: 1.78\u20134.99;\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009&lt;\u20090.0001). Three studies showed that high fetuin-A levels were a protective factor against AVF failure (HR\u2009=\u20090.76; 95% CI: 0.63\u20130.91;\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009=\u20090.003). Low fetuin-A levels were associated with increased vascular calcification and risk of AVF failure in CKD patients undergoing hemodialysis. These findings suggest the potential of fetuin-A as a predictive biomarker and therapeutic target in reducing AVF failure. Further studies with standard testing methods are recommended to confirm this association.\n                  <\/jats:p>","DOI":"10.1177\/11297298251407274","type":"journal-article","created":{"date-parts":[[2026,1,16]],"date-time":"2026-01-16T11:09:37Z","timestamp":1768561777000},"page":"1450-1462","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Fetuin-A as a risk factor for arteriovenous fistula failure in chronic kidney disease patients with hemodialysis through vascular calcification mechanism: Systematic review and meta-analysis"],"prefix":"10.1177","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-8490-1793","authenticated-orcid":false,"given":"Nyoman Paramita","family":"Ayu","sequence":"first","affiliation":[{"name":"Division of Nephrology and Hypertension, Department of Internal Medicine, Faculty of Medicine Udayana University\/Prof. Ngoerah Hospital, Denpasar, Bali, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yenny","family":"Kandarini","sequence":"additional","affiliation":[{"name":"Division of Nephrology and Hypertension, Department of Internal Medicine, Faculty of Medicine Udayana University\/Prof. Ngoerah Hospital, Denpasar, Bali, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-5802-5398","authenticated-orcid":false,"given":"Raka","family":"Widiana","sequence":"additional","affiliation":[{"name":"Division of Nephrology and Hypertension, Department of Internal Medicine, Faculty of Medicine Udayana University\/Prof. Ngoerah Hospital, Denpasar, Bali, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gede Wira","family":"Mahadita","sequence":"additional","affiliation":[{"name":"Division of Nephrology and Hypertension, Department of Internal Medicine, Faculty of Medicine Udayana University\/Prof. Ngoerah Hospital, Denpasar, Bali, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,1,16]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2019.14745"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.22265\/acnef.10.1.629"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11255-017-1515-0"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1159\/000493549"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00424-022-02688-6"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1373\/clinchem.2011.177725"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.5414\/CNP75391"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2369-14-122"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2008.08.032"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.4103\/0971-4065.82128"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1525-1594.2009.00814.x"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.3109\/00365513.2010.528445"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1159\/000494665"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ekir.2020.07.033"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.jrn.2007.10.017"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.mat.0000202606.44826.6b"},{"issue":"6","key":"e_1_3_3_18_2","first-page":"453","article-title":"Comparison of fetuin-A, vitamin D, monounsaturated fatty acid, and vascular calcification on plain radiography between dialysis modalities","volume":"7","author":"Kim HI","year":"2013","unstructured":"Kim HI, An WS. Comparison of fetuin-A, vitamin D, monounsaturated fatty acid, and vascular calcification on plain radiography between dialysis modalities. 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