{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T02:47:25Z","timestamp":1782355645762,"version":"3.54.5"},"reference-count":20,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T00:00:00Z","timestamp":1782259200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: ABO and Rh blood group systems represent clinically relevant genetic polymorphisms with established associations beyond transfusion medicine, including thrombotic risk. We investigated the prevalence of ABO and Rh blood group phenotypes in hemodialysis patients and their associations with documented vascular access thrombosis and all-cause mortality. Materials and Methods: This retrospective cohort study analyzed 3027 patients receiving maintenance hemodialysis in Hatay province, T\u00fcrkiye, between January 2010 and April 2025. Data included ABO and Rh blood group determination, demographics, comorbidities, dialysis vintage, vascular access type, vascular access thrombosis events, and mortality. Multivariable binary logistic regression was used to identify independent factors associated with documented vascular access thrombosis. Multivariable Cox proportional hazards regression with vascular access thrombosis modeled as a time-dependent covariate was used to identify independent predictors of all-cause mortality. Results: Mean patient age was 63.95 \u00b1 13.74 years; 58.3% were men. Blood group A was most prevalent (41.4%), followed by O (35.8%), B (15.9%), and AB (6.9%); 92.7% were Rh-positive. Documented vascular access thrombosis differed significantly by ABO group (p = 0.027), with the highest rate in group A (14.1%). In multivariable logistic regression, non-O blood group (OR 1.34, 95% CI 1.06\u20131.70; p = 0.014) and longer dialysis vintage (OR 1.01 per month, 95% CI 1.00\u20131.01; p &lt; 0.001) were independently associated with documented vascular access thrombosis. In multivariable Cox regression, time-dependent vascular access thrombosis was independently associated with higher all-cause mortality (HR 1.33, 95% CI 1.12\u20131.59; p = 0.002), as were age (HR 1.02; p &lt; 0.001), diabetes mellitus (HR 1.49; p &lt; 0.001), coronary artery disease (HR 1.34; p &lt; 0.001), and hypertension (HR 1.19; p &lt; 0.001). Arteriovenous fistula was associated with lower mortality compared with temporary catheter (HR 0.46, 95% CI 0.37\u20130.58; p &lt; 0.001). Blood group phenotype was not independently associated with all-cause mortality (all p &gt; 0.5 vs. group O). Conclusions: In hemodialysis patients, non-O blood groups were modestly but independently associated with documented vascular access thrombosis, and vascular access thrombosis was independently associated with increased mortality when modeled as a time-dependent exposure. Blood group phenotype was not independently associated with mortality after adjustment for established risk factors. Blood group may contribute incrementally to vascular access risk awareness alongside established clinical risk factors, but its modest absolute risk difference limits standalone clinical utility.<\/jats:p>","DOI":"10.3390\/medicina62071227","type":"journal-article","created":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T01:03:56Z","timestamp":1782349436000},"page":"1227","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Prevalence of ABO Blood Groups and Their Relationship with Vascular Access Thrombosis and Mortality in Hemodialysis Patients"],"prefix":"10.3390","volume":"62","author":[{"given":"Can","family":"H\u00fczmeli","sequence":"first","affiliation":[{"name":"Department of Nephrology, Hatay Training and Research Hospital, Hatay 31060, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7240-0124","authenticated-orcid":false,"given":"Ay\u015fe","family":"\u015eeker","sequence":"additional","affiliation":[{"name":"Department of Nephrology, University of Health Sciences, Bursa City Hospital, Bursa 16009, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1199-1706","authenticated-orcid":false,"given":"Hatice","family":"Orta\u00e7","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, Institute of Health Sciences, Uluda\u011f University, Bursa 16059, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nurettin","family":"Yeral","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Hatay Training and Research Hospital, Hatay 31060, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,6,24]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"830","DOI":"10.1161\/ATVBAHA.119.313658","article-title":"Genetically Determined ABO Blood Group and its Associations with Health and Disease","volume":"40","author":"Groot","year":"2020","journal-title":"Arterioscler. Thromb. Vasc. Biol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"517","DOI":"10.1002\/wsbm.1355","article-title":"Blood type biochemistry and human disease","volume":"8","author":"Ewald","year":"2016","journal-title":"Wiley Interdiscip. Rev. Syst. Biol. Med."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1016\/j.cca.2015.02.016","article-title":"Evolutionary aspects of ABO blood group in humans","volume":"444","author":"Franchini","year":"2015","journal-title":"Clin. Chim. Acta"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"6629060","DOI":"10.1155\/2021\/6629060","article-title":"Human ABO Blood Groups and Their Associations with Different Diseases","volume":"2021","author":"Abegaz","year":"2021","journal-title":"BioMed Res. Int."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1449","DOI":"10.1161\/CIRCULATIONAHA.115.017563","article-title":"ABO Blood Group and Risk of Thromboembolic and Arterial Disease: A Study of 1.5 Million Blood Donors","volume":"133","author":"Vasan","year":"2016","journal-title":"Circulation"},{"key":"ref_6","first-page":"363","article-title":"The Overall Distribution of ABO and Rh (D) Groups in The Most Populous City Istanbul as Representing the Complex Ethnicity of Turkey","volume":"16","author":"Yanasik","year":"2020","journal-title":"Med. J. Bakirkoy"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1064","DOI":"10.1111\/trf.16339","article-title":"ABO blood type association with SARS-CoV-2 infection mortality: A single-center population in New York City","volume":"61","author":"Szymanski","year":"2021","journal-title":"Transfusion"},{"key":"ref_8","first-page":"44","article-title":"Distribution of Hemodialysis Patients According to ABO Blood Groups and Rhesus Factor in the Tripoli Region","volume":"1","author":"Azab","year":"2023","journal-title":"Glob. J. Clin. Med. Med. Res."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"e310522205460","DOI":"10.2174\/03666220531142340","article-title":"Prevalence of ABO Blood Grouping among Hemodialysis Patients in Dubai","volume":"3","author":"Alalawi","year":"2022","journal-title":"New Emir. Med. J."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"425","DOI":"10.1016\/j.cca.2010.11.002","article-title":"Hemodialysis vascular access thrombosis: The role of factor V Leiden, prothrombin gene mutation and ABO blood groups","volume":"412","author":"Rios","year":"2011","journal-title":"Clin. Chim. Acta"},{"key":"ref_11","first-page":"38","article-title":"A study on the correlation of ABO blood group system and hypertension","volume":"3","author":"Sadiq","year":"2017","journal-title":"Int. J. Appl. Dent. Sci."},{"key":"ref_12","first-page":"140","article-title":"Association and Distribution of Hypertension, Obesity and ABO Blood groups in Blood Donors","volume":"2","author":"Chandra","year":"2012","journal-title":"Iran. J. Pediatr. Hematol. Oncol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"e270422204139","DOI":"10.2174\/1573399818666220427124448","article-title":"Association between ABO Blood Groups and Type 2 Diabetes Mellitus: A Meta-Analysis","volume":"19","author":"Cano","year":"2023","journal-title":"Curr. Diabetes Rev."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"3000605221129547","DOI":"10.1177\/03000605221129547","article-title":"Relationships of ABO and Rhesus blood groups with type 2 diabetes mellitus: A systematic review and meta-analysis","volume":"50","author":"Getawa","year":"2022","journal-title":"J. Int. Med. Res."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Ye, Z., Wu, Y., Tu, Y., Chen, M., Gao, Y., Shi, L., Li, P., Xie, E., Guo, Z., and Li, Q. (2022). Blood Group O Protect End-Stage Renal Disease Patients with Dialysis from Coronary Artery Disease. Front. Cardiovasc. Med., 8.","DOI":"10.3389\/fcvm.2021.821540"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"492","DOI":"10.1093\/aje\/kwm324","article-title":"Immortal time bias in pharmacoepidemiology","volume":"167","author":"Suissa","year":"2008","journal-title":"Am. J. Epidemiol."},{"key":"ref_17","first-page":"317","article-title":"ABO blood group and COVID-19: An updated systematic literature review and meta-analysis","volume":"19","author":"Franchini","year":"2021","journal-title":"Blood Transfus."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"100785","DOI":"10.1016\/j.blre.2020.100785","article-title":"The impact of ABO blood group on COVID-19 infection risk and mortality: A systematic review and meta-analysis","volume":"48","author":"Liu","year":"2021","journal-title":"Blood Rev."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1186\/s13613-021-00844-2","article-title":"ABO blood types and sepsis mortality","volume":"11","author":"Itenov","year":"2021","journal-title":"Ann. Intensive Care"},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Ng, M.S.Y., Ullah, S., Wilson, G., McDonald, S., Sypek, M., and Mallett, A.J. (2020). ABO blood group relationships to kidney transplant recipient and graft outcomes. PLoS ONE, 15.","DOI":"10.1371\/journal.pone.0236396"}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/62\/7\/1227\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T02:21:55Z","timestamp":1782354115000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/62\/7\/1227"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,24]]},"references-count":20,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2026,7]]}},"alternative-id":["medicina62071227"],"URL":"https:\/\/doi.org\/10.3390\/medicina62071227","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,24]]}}}