Supplementary file 1_Coronary artery calcium burden and metabolic indices in relation to arteriovenous fistula functionality and post-functionality failure.docx

Whether coronary artery calcium (CAC), a marker of systemic vascular calcification, is associated with either outcome is unclear; competing events are frequently ignored.</p>Objective<p>To examine CAC and metabolic markers in relation to AVF functionality and post-functionality AVF failure.</p>Methods<p>In this single-centre retrospective cohort, 645 patients with end-stage kidney disease underwent first-time radiocephalic AVF creation.

The primary outcome was functionality failure (n = 139 events; assisted functionality or abandonment before cannulation), with unassisted functionality, death and transplantation as competing events. A secondary outcome was post-functionality AVF failure among 568 fistulas that achieved successful functionality, with death and transplantation as competing events. Fine–Gray subdistribution hazard models were fitted after multiple imputation (n = 20).</p>Results<p>Independent predictors of functionality failure were age (subdistribution hazard ratio [SHR] 1.53, 95% confidence interval [CI] 1.22–1.93, P < 0.001 per 1 standard deviation [SD]), CAC score (SHR 1.21, 95% CI 1.06–1.38, P = 0.004 per 1 SD) and left ventricular diastolic dysfunction (SHR 1.44, 95% CI 1.02–2.04, P = 0.040).