Inflammatory Biomarkers in Arteriovenous Fistula Maturation Failure: A systematic Review

Abstract

Arteriovenous fistula (AVF) is the preferred vascular access for maintenance hemodialysis in patients with end-stage renal disease. However, maturation failure remains a frequent and costly clinical challenge, adversely affecting dialysis adequacy, patient outcomes, and healthcare expenditure. Accumulating evidence indicates that systemic inflammatory biomarkers, including the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammation index (SII), prognostic nutritional index (PNI), and calcium-phosphorus product, may function as accessible and cost-effective tools for predicting AVF maturation failure. This review examines the current literature on the role of these inflammatory and nutritional indices in forecasting AVF dysfunction, examines associated clinical and demographic risk factors, and discusses the practical implications for preoperative risk stratification in hemodialysis populations.