Association of Various Point Mutations as Risk Factors for Synthetic Graft Thrombosis in African American Hemodialysis Patients

Single-nucleotide polymorphisms in the genes that code for coagulation factor V (factor V (Leiden)) and II (prothrombin G20210A), as well as the methyltetrahydrofolate reductase (MTHFR) have been implicated in the majority of cases of hereditary thrombophilia. In our hemodialysis patient population, comprised mainly of African Americans, we have seen a high incidence of early vascular access thrombosis without any identifiable predisposing factors. In some instances, there is recurrent access thrombosis that may be related to an inherited condition. In this study we evaluated the presence of these gene mutations and their association with increased risk of recurrent vascular access thrombosis in our hemodialysis patient population. Our results show that factor V Leiden and factor II prothrombin point mutations did not appear to increase the risk of vascular access thrombosis in African Americans with end-stage renal disease on hemodialysis. Patients heterozygous for the MTHFR gene, also did not show a significant increased risk for synthetic graft thrombosis.