Browsing by Author "Ari, Elif"

Now showing 1 - 17 of 17

Accelerated Atherosclerosis in Haemodialysis Patients; Correlation of Endothelial Function With Oxidative Dna Damage
(Oxford Univ Press, 2012) Kaya, Yuksel; Ari, Elif; Demir, Halit; Soylemez, Nihat; Cebi, Aysegul; Alp, Hakan; Beytur, Ali
Background. Accelerated atherosclerosis is the major cause of mortality in patients on chronic haemodialysis (HD). The aim of this study was to evaluate the relationship between oxidative DNA damage [8-hydroxy-2'-deoxyguanosine/deoxyguanosine ratio (8-OHdG/dG ratio)], oxidative stress biomarkers and endothelial function in HD patients as an indicator of atherosclerosis. Methods. Forty-four chronic HD patients without known atherosclerotic disease and 55 age- and sex-matched healthy individuals were included in the study. Plasma malondialdehyde (MDA) levels and 8-OHdG/dG ratio were determined as oxidative stress markers. Superoxide dismutase (SOD) and glutathione peroxidase (GPx) activities were measured as antioxidants. Endothelial function was assessed by ultrasonography. Results. 8-OHdG/dG ratio and MDA levels were higher in HD patients than controls while SOD and GPx activities were lower in HD patients compared to controls. Flow-mediated dilatation FMD% in HD patients were lower than the control group (7.28 +/- 0.79 versus 11.18 +/- 0.82, P < 0.001). There was a significant negative correlation between FMD% and 8-OHdG/dG ratio (r = -0.678, P < 0.01) and MDA levels (r = 0.517, P < 0.01), while there was a significant positive correlation between FMD% and SOD (r = 0.538, P < 0.01) and GPx levels (r = 0.720, P < 0.01). Conclusions. Our data have demonstrated that HD patients exhibit increased oxidative DNA damage and decreased antioxidant activity. We propose that endothelial function is negatively correlated with 8-OHdG/dG ratio and positively correlated with antioxidant enzymes. To our knowledge, this is the first study to demonstrate the inverse relationship between endothelial function and plasma oxidative DNA damage in HD patients.
Cinacalcet May Improve Oxidative Dna Damage in Maintenance Hemodialysis Patients: an Observational Study
(Springer, 2014) Ari, Elif; Kaya, Yuksel; Demir, Halit; Asicioglu, Ebru; Eren, Zehra; Celik, Eray; Arikan, Hakki
Oxidative stress is accepted as a non-classical cardiovascular risk factor in patients on maintenance hemodialysis (HD). The aim of this study was to evaluate the impact of cinacalcet on oxidative stress biomarkers, oxidative DNA damage (8-hydroxy-2'-deoxyguanosine/deoxyguanosine), endothelial function (FMD %) and carotid artery intima-media thickness (CIMT) in HD patients. Forty-two chronic HD patients with secondary hyperparathyroidism undergoing 60 mg/day cinacalcet treatment with a follow-up of 6 months and 38 age- and sex-matched healthy individuals were included in this prospective study. Plasma malondialdehyde (MDA) levels and 8-hydroxy-2'-deoxyguanosine/deoxyguanosine ratio (8-OHdG/dG) were determined as oxidative stress markers. Superoxide dismutase (SOD), paraoxonase (PON), catalase (CAT), carbonic anhydrase (CAN) and glutathione peroxidase (GPx) activities were measured as antioxidants. FMD % and CIMT were assessed by ultrasonography. MDA levels were decreased; SOD, PON, CAT, CAN and GPx activities were increased after 6 months of cinacalcet treatment in HD patients. Although CIMT remained stabile, there was a significant improvement in FMD % as well as a notable reduction trend in 8-OHdG/dG ratio after 6 months of treatment. Our data have demonstrated that cinacalcet improves oxidative stress, genomic damage, endothelial function and increases antioxidant protection in HD patients after 6 months of treatment.
The Correlation of Serum Trace Elements and Heavy Metals With Carotid Artery Atherosclerosis in Maintenance Hemodialysis Patients
(Springernature, 2011) Ari, Elif; Kaya, Yuksel; Demir, Halit; Asicioglu, Ebru; Keskin, Siddik
Changes in essential trace elements and heavy metals may affect the atherosclerotic state of patients on maintenance hemodialysis (HD). The aim of the study was to evaluate the relation between the serum levels of some trace elements and heavy metals (iron, zinc, manganese, copper, magnesium, cobalt, cadmium, lead, and copper/zinc ratio) and carotid artery intima-media thickness (CIMT) in HD patients. Fifty chronic HD patients without known atherosclerotic disease and 48 age- and sex-matched healthy individuals were included in the study. The serum levels of trace elements (iron, zinc, manganese, copper, and magnesium) and heavy metals (cobalt, cadmium, and lead) were measured by Atomic Adsorption Spectrophotometer (UNICAM-929). CIMT was assessed by carotid artery ultrasonography. The serum levels of iron, zinc, and manganese were lower; levels of copper, magnesium, cobalt, cadmium, lead, and copper/zinc ratio were higher in HD patients compared to controls. CIMT in HD patients were higher than the control group (0.64 +/- 0.11 vs 0.42 +/- 0.05, p < 0.001). There was a significant negative correlation between CIMT and serum levels of zinc (r = -0.70, p < 0.01), iron (r = -0.71, p < 0.01), and manganese (r = -0.47, p < 0.01), while there was a significant positive correlation between CIMT and serum levels of copper (r = 0.63, p < 0.01), magnesium (r = 0.77, p < 0.01), cobalt (r = 0.63, p < 0.01), cadmium (r = 0.48, p < 0.01), lead (r = 0.38, p < 0.01), and copper/zinc ratio (r = 0.68, p < 0.01). A linear regression analysis showed that serum levels of magnesium, cadmium, lead, and copper/zinc ratio were still significantly and positively correlated with CIMT. We propose that copper/zinc ratio, magnesium and toxic metals cadmium and lead are independent determinants of CIMT in maintenance HD patients without known atherosclerotic disease.
Decreased Serum Selenium Levels Are Correlated With Diminished Coronary Flow Reserve Among Hemodialysis Patients
(Humana Press inc, 2013) Atakan, Aydin; Macunluoglu, Beyza; Kaya, Yuksel; Ari, Elif; Demir, Halit; Asicioglu, Ebru; Kaspar, Cigdem
Cardiovascular diseases are the main reason of high mortality among hemodialysis patients. Decreased serum selenium levels may have a role in accelerated atherosclerosis in this patient group. The hypothesis of this study was to show a correlation between decreased serum selenium levels and coronary flow reserve as an indicator of endothelial dysfunction and atherosclerosis in HD patients. Seventy-one chronic hemodialysis patients and age 65 and sex-matched healthy controls were included in the study. Plasma selenium levels were measured by spectrophotometry, and coronary flow reserve was assessed by transthoracic Doppler echocardiography. Serum selenium levels (34.16 +/- 6.15 ng/ml vs. 52.4 +/- 5.51 ng/ml, P < 0.001) and coronary flow reserve values (1.73 +/- 0.11 vs. 2.32 +/- 0.28, P < 0.001) were significantly lower in hemodialysis patients compared with controls, respectively. There was a significant positive correlation between coronary flow reserve and serum levels of selenium (r = 0.676, P < 0.001). A linear regression analysis showed that serum levels of selenium were independently and positively correlated with coronary flow reserve (regression coefficient = 0.650, P < 0.05). This study was the first to show a positive and independent correlation between decreased selenium levels and diminished coronary flow reserve as an indicator of endothelial dysfunction and atherosclerosis in hemodialysis patients. Our data suggest that decreased serum selenium levels may facilitate the development of endothelial dysfunction and disruption of coronary flow reserve which occur before the development of overt atherosclerosis.
The Effect of Vitamin E Prophylaxis on Experimental Amikacin-Induced Nephrotoxicity Model
(Oxford Univ Press, 2016) Bulut, Gulay; Ari, Elif; Basbugan, Yildiray; Alp, Hamit Hakan; Bayram, Irfan
Effects of Lowering Dialysate Sodium on Carotid Artery Atherosclerosis and Endothelial Dysfunction in Maintenance Hemodialysis Patients
(Springer, 2012) Gumrukcuoglu, Hasan Ali; Ari, Elif; Akyol, Aytac; Akdag, Serkan; Simsek, Hakki; Sahin, Musa; Tuncer, Mustafa
Purpose Our aim in this study was to examine the effects of low-sodium dialysate on carotid artery atherosclerosis, endothelial dysfunction, and blood pressure (BP) in maintenance hemodialysis (HD) patients. Methods After baseline measurements were obtained, the dialysate sodium concentration was reduced from 140 to 137 mEq/L. Carotid artery intima-media thickness (CIMT) and flow-mediated dilatation (FMD %) were measured before and after 6 months of HD with low-sodium dialysate. Interdialytic weight gain (IDWG), pre- and post-dialysis BP, and dialysis-related symptoms were monitored during the study. Results Fifty-two patients were enrolled, and 41 patients completed the study. Twenty-one patients had hypertension and were receiving antihypertensive medications. The average number of antihypertensive drugs per patient was 1.9 +/- 0.8. There was no significant reduction in BP at the end of the study, but the average number of antihypertensive drugs was reduced to 1.2 +/- 0.4 (P < 0.001). There were significant improvements in CIMT (P = 0.003) and FMD (P < 0.001) with low-sodium HD. The IDWG decreased significantly during the low-sodium dialysate treatment (P < 0.001). However, hypotensive episodes and cramps were more frequent during the study period. Conclusions Our study demonstrated that the lowering of dialysate sodium concentration reduced CIMT, improved FMD, and provided better control of IDWG and BP, but increased the incidence of dialysis-related symptoms.
Epicardial Fat Thickness Is Associated With Impaired Coronary Flow Reserve in Hemodialysis Patients
(Wiley, 2014) Atakan, Aydin; Macunluoglu, Beyza; Kaya, Yuksel; Ari, Elif; Demir, Halit; Asicioglu, Ebru; Kaspar, Cigdem
Cardiovascular disease (CVD) is the main cause of mortality in hemodialysis (HD) patients. Epicardial fat tissue (EFT) is a new risk factor in CVD. The aim of this study was to evaluate the association between EFT and coronary artery flow reserve (CFR), which is an early indicator of endothelial dysfunction in coronary vessels of HD patients. We performed a cross-sectional study including 71 chronic HD patients and 65 age- and sex-matched healthy controls. Epicardial fat tissue was significantly higher in HD patients when compared to healthy controls (6.53 +/- 1.01 mm vs. 5.79 +/- 1.06 mm, respectively, P < 0.001). On transthoracic Doppler echocardiography, CFR values were significantly lower in HD patients when compared to healthy controls (1.73 +/- 0.11 vs. 2.32 +/- 0.28, P < 0.001). Correlation analysis showed CFR values to be inversely correlated with EFT (r = -0.287, P < 0.05). Multiple linear regression analysis was used to define independent determinants of EFT in HD patients. Artery flow reserve, age, body mass index and total cholesterol levels were independently correlated with EFT thickness. This study demonstrated that EFT was significantly higher among HD patients compared to healthy controls. In addition, this study was the first to demonstrate an inverse correlation between EFT and CFR in this patient population.
Epicardial Fat Tissue Thickness Is Correlated With Diminished Levels of Co-Enzyme Q10, a Major Antioxidant Molecule Among Hemodialysis Patients
(Pergamon-elsevier Science Ltd, 2014) Macunluoglu, Beyza; Atakan, Aydin; Ari, Elif; Kaya, Yuksel; Kaspar, Cigdem; Demir, Halit; Alp, Hamit Hakan
Objectives: Accelerated atherosclerosis is the major cause of mortality in patients on chronic maintenance hemodialysis (HD). Epicardial fat tissue (EFT) is a new risk factor in cardiovascular disease (CVD). The aim of this study was to evaluate the relation between plasma coenzyme Q10 levels (Co-Q10) which is a potent physiologic antioxidant and EFT thickness in HD patients. Design and methods: Seventy one chronic HD patients and 65 age and sex matched healthy individuals were included in the study. Plasma Co-Q10 levels were performed by high-performance liquid chromatography (HPLC) measurements. EFT was measured by transthoracic echocardiograpy (TTE) performed with a VIVID 7 instrument. Results: Plasma Co-Q10 levels (1.36 +/- 0.43 vs 2.53 +/- 0.55, p < 0.001) were significantly lower in HD patients compared to controls. EFT was significantly increased in HD patients compared to healthy controls (6.53 +/- 1.01 vs. 5.79 +/- 1.06 mm respectively, p < 0.001). Correlation analysis showed that plasma Co-Q10 levels were inversely correlated with EFT (r = -0.263, p < 0.05). Multiple linear regression analysis was used to define independent determinants of EFT in HD patients. According to linear regression analysis, age, BMI, total cholesterol and Co-Q10 levels were found to be independent predictors of EFT (adjusted r(2) = 0.38, p < 0.001). Conclusion: This study demonstrated that EFT thickness was significantly higher among HD patients compared to healthy controls. In addition; this study was the first to demonstrate an inverse correlation between EFT thickness and Co-Q10 levels in this patient population. (C) 2014 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.
Lowering Dialysate Sodium Improves Systemic Oxidative Stress in Hemodialysis Patients; Results of a Small-Scale, Prospective Study
(Oxford Univ Press, 2015) Ari, Elif; Gumrukcuoglu, Hasan; Demir, Halit; Yavuz, Ahmet; Keskin, Siddik; Macunluoglu, Beyza; Atakan, Aydin
Lowering Dialysate Sodium Improves Systemic Oxidative Stress in Maintenance Hemodialysis Patients
(Springer, 2016) Macunluoglu, Beyza; Gumrukcuoglu, Hasan Ali; Atakan, Aydin; Demir, Halit; Alp, Hamit Hakan; Akyol, Aytac; Ari, Elif
The purpose of the current prospective study was to evaluate the effects of low sodium dialysate on oxidative stress parameters, blood pressure (BP) and endothelial dysfunction in maintenance hemodialysis (HD) patients. After baseline measurements were taken, the dialysate sodium concentration was reduced from 140 to 137 mEq/L. Oxidative stress parameters and flow-mediated dilatation (FMD %) were measured before and after 6 months of HD with low sodium dialysate. Interdialytic weight gain (IDWG) and pre- and post-dialysis BP were monitored during the study. A total of 52 patients were enrolled and 41 patients completed the study. There was a significant reduction in systolic blood pressure at the end of the study [130.00 (90.00-190.00) vs. 120.00 (90.00-150.00), p < 0.001]. Similarly, there were significant improvements in IDWG [2670.00 (1670.00-4300.00) vs. 1986.00 (1099.00-3998.00), p < 0.001] and FMD % [7.26 (4.55-8.56) vs. 9.56 (6.55-12.05), p < 0.001]. Serum MDA levels (p < 0.001) were significantly decreased; serum SOD (p < 0.001) and GPx (p < 0.001) activities were significantly increased after low sodium HD compared to standard sodium HD. Our data seem to suggest a potential role of 137 mEq/L sodium dialysate for improving hemodynamic status, endothelial function and reducing oxidative stress than 140 mEq/L sodium dialysate in maintenance HD patients.
Oxidative Dna Damage Correlates With Carotid Artery Atherosclerosis in Hemodialysis Patients
(Wiley, 2011) Ari, Elif; Kaya, Yuksel; Demir, Halit; Cebi, Aysegul; Alp, Hamit Hakan; Bakan, Ebubekir; Keskin, Siddik
Oxidative stress is accepted as a nonclassical cardiovascular risk factor in chronic renal failure patients. The aim of this study was to evaluate the relation between oxidative DNA damage (8-hydroxy-2'-deoxyguanosine/deoxyguanosine [8-OHdG/dG] ratio), oxidative stress biomarkers, antioxidant enzymes, and carotid artery intima-media thickness (CIMT) in hemodialysis (HD) patients. Forty chronic HD patients without known atherosclerotic disease and 48 age-and sex-matched healthy individuals were included in the study. Plasma malondialdehyde (MDA) levels and 8-OHdG/dG ratio were determined as oxidative stress markers. Superoxide dismutase (SOD) and glutathione peroxidase (GPx) activities were measured as antioxidants. CIMT was assessed by carotid artery ultrasonography. 8-OHdG/dG ratios and MDA levels were higher; SOD and GPx activities were lower in HD patients compared to controls. HD patients had significantly higher CIMT compared to controls (0.61 +/- 0.08 vs. 0.42 +/- 0.05, p < 0.001). There was a significant positive correlation between CIMT and 8-OHdG/dG ratio (r = 0.57, p < 0.01) and MDA levels (r = 0.41, p < 0.01), while there was a significant negative correlation between CIMT and SOD (r = -0.47, p < 0.01) and GPx levels (r = -0.62, p < 0.01). It is firstly demonstrated that CIMT is positively correlated with oxidative DNA damage in HD patients without known atherosclerotic disease.
Paricalcitol May Improve Oxidative Dna Damage on Experimental Amikacin-Induced Nephrotoxicity Model
(Taylor & Francis Ltd, 2016) Bulut, Gulay; Basbugan, Yildiray; Ari, Elif; Erten, Remzi; Bektas, Havva; Alp, Hamit Hakan; Bayram, Irfan
This study aimed to investigate the possible protective effect of paricalcitol on experimental amikacin-induced nephrotoxicity model in rats. Wistar albino rats (n=32) were allocated into four equal groups of eight each, the control (Group C), paricalcitol (Group P), amikacin-induced nephrotoxicity (Group A), and paricalcitol-treated amikacin-induced nephrotoxicity (Group A+P) groups. Paricalcitol was given intra-peritoneally at a dose of 0.4g/kg/d for 5 consecutive days prior to induction of amikacin-induced nephrotoxicity. Intra-peritoneal amikacin (1.2g/kg) was used to induce nephrotoxicity at day 4. Renal function parameters, oxidative stress biomarkers, oxidative DNA damage (8-hydroxy-2-deoxyguanosine/deoxyguanosine ratio), kidney histology, and vascular endothelial growth factor (VEGF) immunoexpression were determined. Group A+P had lower mean fractional sodium excretion (p<0.001) as well as higher creatinine clearance (p=0.026) than the amikacin group (Group A). Renal tissue malondialdehyde levels (p=0.035) and serum 8-hydroxy-2-deoxyguanosine/deoxyguanosine ratio (8-OHdG/dG ratio) (p<0.001) were significantly lower; superoxide dismutase (p=0.024) and glutathione peroxidase (p=0.007) activities of renal tissue were significantly higher in group A+P than in group A. The mean scores of tubular necrosis (p=0.024), proteinaceous casts (p=0.038), medullary congestion (p=0.035), and VEGF immunoexpression (p=0.018) were also lower in group A+P when compared with group A. This study demonstrates the protective effect of paricalcitol in the prevention of amikacin-induced nephrotoxicity in an experimental model. Furthermore, it is the first study to demonstrate that paricalcitol improves oxidative DNA damage in an experimental acute kidney injury model.
Paricalcitol May Improve Oxidative Dna Damage on Experimental Amikacin-Induced Nephrotoxicity Model
(Oxford Univ Press, 2016) Bulut, Gulay; Basbugan, Yildiray; Ari, Elif; Alp, Hamit Hakan; Bayram, Irfan
Saphenous Vein or Basilic Vein Transposition in Hemodialysis Patients
(Turk Nefroloji Diyaliz Transplantasyon dergisi, 2011) Odabasi, Dolunay; Ari, Elif; Ekim, Hasan
OBJECTIVE: Secondary arteriovenous fistula (AVF) management with saphenous vein (SV) graft and basilic vein transposition (BVT) in HD-dependent patients are good alternatives. A concurrent series of patients was reviewed to evaluate the patency and complication rates after AVF formation. MATERIAL and METHODS: From January 2006 to January 2010, 40 secondary HD access procedures were performed in 40 consecutive patients. All access procedures were planned on the basis of preoperative duplex ultrasonography (USG) scans of arm and forearm veins. Functional patency was defined as the ability to cannulate the patient for HD successfully. Primary and secondary cumulative functional patency of SV grafts and BVT's were determined with the Kaplan Meier test, differences were analyzed with Log Rank test, and differences in revision rates including thrombolysis thrombectomies and operative revisions were analyzed with the Z test and the Fisher exact T test. RESULTS: Mean follow up was 48 months (range 43-54 months). Risk factors were similar between the two groups. SV group and BVT group had similar patency ratings. The HD access complication rates were higher in the SV group. CONCLUSION: Our data strongly support the notion that the BVT must always be considered before an SV graft as long as the patient is a candidate for an upper arm secondary AVF creation based on anatomical criteria.
Serum Cadmium Levels Are Independently Associated With Endothelial Function in Hemodialysis Patients
(Springer, 2012) Kaya, Yuksel; Ari, Elif; Demir, Halit; Gecit, Ilhan; Beytur, Ali; Kaspar, Cigdem
Hemodialysis (HD) patients are at risk of deficiency of essential trace elements and excess of toxic trace elements. The aim of the study was to evaluate the relation between the serum levels of some trace elements and heavy metals (iron, zinc, manganese, copper, magnesium, cobalt, cadmium, and lead) and endothelial function in HD patients. Forty-eight chronic HD patients without known atherosclerotic disease and 42 age- and sex-matched healthy individuals were included in the study. The serum levels of trace elements (iron, zinc, manganese, copper, and magnesium) and heavy metals (cobalt, cadmium, and lead) were measured by Atomic Adsorption Spectrophotometer (UNICAM-929). The serum levels of iron, zinc, and manganese were lower, and levels of copper, magnesium, cobalt, cadmium, and lead were higher in HD patients compared to controls. Flow-mediated dilatation (FMD %) in HD patients was lower than that in the control group (7.27 +/- A 0.76 vs. 11.29 +/- A 0.82, P < 0.001). There was a significant negative correlation between FMD % and serum levels of cobalt (r = -0.313, P = 0.03) and cadmium (r = -0.524, P < 0.01). A linear regression analysis showed that serum cadmium levels were still significantly and negatively correlated with FMD % (regression coefficient = -0.526, P < 0.001). We first demonstrated that serum cadmium levels independently predict endothelial function in HD patients without known atherosclerotic disease.
Serum Coenzyme Q10 Levels Are Associated With Coronary Flow Reserve in Hemodialysis Patients
(Wiley, 2013) Macunluoglu, Beyza; Kaya, Yuksel; Atakan, Aydin; Ari, Elif; Kaspar, Cigdem; Demir, Halit; Kedrah, Alla Eldeen
Accelerated atherosclerosis is the major cause of mortality in patients on chronic hemodialysis (HD). The aim of this study was to evaluate the relation between coenzyme Q10 (CoQ10) levels and coronary flow reserve (CFR) in HD patients as an indicator of atherosclerosis. Seventy-one chronic HD patients and 65 age- and sex-matched healthy individuals were included in the study. Plasma CoQ10 levels were performed by high-performance liquid chromatography measurements. CFR was assessed by transthoracic Doppler echocardiography. Serum CoQ10 levels (1.36 +/- 0.43 vs. 2.53 +/- 0.55, P<0.001) and CFR values (1.73 +/- 0.11 vs. 2.32 +/- 0.28, P<0.001) were significantly lower in HD patients compared with controls. There was a significant positive correlation between CFR and serum levels of CoQ10 (r=0.669, P<0.001). A linear regression analysis showed that serum levels of CoQ10 were still significantly and positively correlated with CFR (regression coefficient=0.235, P<0.001). Our data have demonstrated that HD patients exhibit decreased plasma CoQ10 levels and CFR values. The study also showed for the first time that serum CoQ10 levels independently predict CFR in HD patients.
Should We Use Saphenous Vein Graft Instead of Synthetic Graft for Creation of Secondary Arteriovenous Fistula in Hemodialysis Dependent End Stage Renal Failure Patients
(Baycinar Medical Publ-baycinar Tibbi Yayincilik, 2012) Odabasi, Dolunay; Ari, Elif; Kiymaz, Adem; Ekim, Hasan
Background: Patient groups with secondary arteriovenous fistula (AVF) management with saphenous vein (SV) graft and polytetrafluoroethylene (PTFE) graft for hemodialysis (HD) were reviewed in terms of patency and complication rate. Methods: Forty HD access procedures were performed in 40 consecutive patients between January 2006 and January 2010. All access procedures were planned on the basis of preoperative duplex ultrasonography (USG) scans of arm and forearm veins. Functional patency was defined as ability to cannulate for HD successfully for the patient. Primary and secondary cumulative functional patency of SV and PTFE grafts were determined with Kaplan Meier test; differences in patency rates were analyzed with Log Rank test and differences in revision rates including thrombolysis, thrombectomies and operative revisions were analyzed with the Z test and the Fisher's exact t-test. Results: Mean follow-up was 48 months (range 43-54 months). Risk factors were similar between the two groups. Saphenous vein graft had better patency rates. The HD access complications were higher in SV graft group, while infection and thrombosis were higher in PTFE group. Conclusion: Our data strongly support the necessity that SV graft should be considered initially, compared to PTFE graft, for the patient who is a candidate for an upper arm secondary AVF creation based on anatomical criteria.