Moreover, the effects of theklothogene on osteoporosis19), nonverbal reasoning26)and cardioembolic strokes18)in human diseases have been suggested to be altered by female hormones27). Of the 126 patients, the genotype frequency of G-395A was 72.2% for GG (n=91), 24.6% for GA (n=31), and 3.2% for AA (n=4), and the frequency of minor allele was 0.155. Clinical data were similar between the two groups, divided according to the status of the A allele. Early dysfunction occurred in 34 (27.0%) of patients, but it occurred at a significantly higher rate in A allele service providers Ombitasvir (ABT-267) (45.7%, 16/35) than in noncarriers (19.8%, 18/91;p=0.003). == Conclusions == Our results suggest that theklothoG-395A polymorphism could be a risk factor for early dysfunction of vascular access in HD patients. Keywords:klotho, Arteriovenous access, Hemodialysis == INTRODUCTION == Vascular access dysfunction, causing considerable morbidity and mortality, is one of the most important complications in hemodialysis (HD) patients1-4). In addition, this dysfunction is usually common; it occurs in up to 30% of patients in the early period following access placement operations4-7). The major pathophysiologic mechanism is usually venous thrombosis, following stenosis near the anastomosis site5-7). Several studies have reported that vascular access dysfunction is related to clinical factors (diabetes, old age), biochemical factors (abnormalities of cytokines, cholesterol, apolipoproteins, hemostasis-derived factors), and vascular factors (vessel size, decreased blood flow rate, intimal hyperplasia, atherosclerosis)8-12). In addition, some studies have shown that point mutations in proteins involved in the coagulation system and proinflammatory cytokines associated with endothelial dysfunction and vessel wall proliferation are related to thrombosis and atherosclerosis9-12). The overall biological effect of theklothogene is usually suppression of the aging process; mice that over-express theklothogene have an increased life span13). Kuro-o et al.14)reported that in an experimental mouse model,klothogene defects induced premature aging processes, including osteoporosis, infertility, senile atrophy of the gonads, thymus, and skin, physical inactivity, and pulmonary emphysema. They also suggested its involvement in progressive vascular atherosclerosis and vascular calcification14). Other studies in humans have demonstrated that this functional variant of theklothogene (KLVS) is usually associated with longevity and early-onset occult coronary artery diseases (CADs)15,16). This Ombitasvir (ABT-267) variant of theklothogene has been shown to be associated with high-density lipoprotein (HDL) cholesterol, systolic blood pressure, and stroke, suggesting an association of this genetic variance with vascular atherosclerosis15). In a Korean populace, Rhee et al17)showed that someklothogene polymorphisms were related to coronary artery disease and hypertension. Kim et al18)also reported thatklothogene polymorphisms were risk factors for ischemic stroke. Notably, theklothogene G-395A polymorphism was shown to be related to these atherosclerotic Ombitasvir (ABT-267) diseases in both studies. The present study was conducted to investigate the relationship between theklothoG-395A polymorphism and early vascular access dysfunction in Korean HD patients. == MATERIALS AND METHODS == == Study subjects == Between Ombitasvir (ABT-267) January 1999 and December 2002, 126 consecutive patients who underwent vascular access creation surgery by an experienced doctor at our hospital were placed on maintenance HD at our hospital and an affiliated clinic. All were enrolled in the study. Patients with a history of previous access failure, those who experienced any problems with central veins on preoperative venography, and those who had access failures within the first 8 weeks after surgery were excluded. This study was approved by the institutional ethics committee of our hospital. All participants provided written informed consent after being given a complete description of the study. Cd24a == Clinical assessment == Clinical data collected from medical records included age, gender, underlying diseases, vascular disease, quantity of antihypertensive drugs, fasting glucose level, HbA1c, serum albumin, total cholesterol, triglycerides, HDL cholesterol, LDL cholesterol, serum calcium and phosphorus, intact PTH, and the type and location of vascular access. Mean serum levels at three time points (the time at which dysfunction was detected, the day of the operation, and 2 months before surgery) were obtained from the laboratory data. == Definition of early dysfunction of vascular access == Early Ombitasvir (ABT-267) dysfunction of vascular access was defined as a situation requiring any angiographic.