Background: Vascular access thrombosis represents a major cause of morbidity in the hemodialysis population. The role of serum lipid profile in access thrombosis is not sufficiently established. The aim of this study was to investigate the association between serum lipid profile and native arteriovenous fistula (AVF) thrombosis. Methods: Clinical files of 99 maintenance hemodialysis patients were reviewed retrospectively for 3 years. Serum lipid profile, albumin and C-reactive protein (CRP) were measured. Catheter angiography was performed in patients with AVF dysfunction and AVF thrombosis. Results: Patients with AVF thrombosis and patent AVF had similar serum levels of total cholesterol and triglyceride levels. However, patients with AVF thrombosis had significantly lower low- density lipoprotein cholesterol, highdensity lipoprotein cholesterol and albumin and higher serum CRP levels than patients with patent AVFs. Conclusions: Serum levels of lipid subfractions are associated with AVF thrombosis in maintenance hemodialysis patients. Larger and prospective cohort studies are needed to confirm these observations. Copyright (c) 2008 S. Karger AG, Basel.