ArticleClinical kidney journal2026
Elevated serum TMAO levels associate with higher risk of arteriovenous vascular access thrombosis in hemodialysis patients.
Article in Clinical kidney journal, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Arteriovenous access thrombosis is a major cause of morbidity in patients receiving maintenance hemodialysis, and conventional clinical and anatomical risk factors do not fully explain its occurrence. Trimethylamine- Methods: We conducted a multicenter prospective cohort study including 375 adult patients undergoing maintenance hemodialysis at 12 centers in Taiwan. Baseline serum TMAO concentrations were measured using liquid chromatography-tandem mass spectrometry and analyzed as tertiles and as a log-transformed continuous variable. Participants were followed for a median of 24 months. The primary outcome was time to first arteriovenous access thrombosis. Associations were evaluated using Cox proportional hazards models with multivariable adjustment and restricted cubic spline analyses. Results: During a median follow-up of 24 months, 88 patients (23%) experienced arteriovenous access thrombosis. Thrombosis incidence increased stepwise across TMAO tertiles (13%, 23%, and 34%; Conclusion: Higher serum TMAO levels were independently associated with an increased risk of arteriovenous access thrombosis in patients undergoing hemodialysis. These findings suggest that TMAO reflects a systemic prothrombotic milieu relevant to dialysis arteriovenous access and support further studies to determine whether TMAO represents a modifiable pathway or a biomarker of uremic thrombotic susceptibility.
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