Maturing arteriovenous accesses in incident haemodialysis patients and first-year outcomes.

Maturing arteriovenous accesses in incident haemodialysis patients and first-year outcomes. J Vasc Access. 2019 Sep 13;:1129729819874531 Authors: McGill RL, Lacson EK Abstract INTRODUCTION: Nephrologists have increased arteriovenous access placement in patients with chronic kidney disease. Not yet usable 'maturing' arteriovenous fistulas and grafts are nearly as common as mature arteriovenous fistulas or grafts. Little has been reported about patients initiating haemodialysis with unready arteriovenous fistulas or grafts. METHODS: The United States Renal Data System records for all adult patients initiating haemodialysis with central venous catheters between July 2010 and December 2011. Patients were categorized by whether a maturing arteriovenous fistula or graft was present. Transition to working arteriovenous fistula or graft was determined from linked Medicare claims. Modality changes and survival were ascertained. A logistic model for one-year survival and a subdistribution hazards model for transition to working arteriovenous fistula or graft, accounting for the competing risk of death, were constructed. RESULTS: Compared to central venous catheter-only, maturing arteriovenous fistula or graft was associated with access conversion (hazard ratio = 2.23 (2.17-2.30) and 3.25 (2.97-3.56), respectively, p 
Source: The Journal of Vascular Access - Category: Surgery Tags: J Vasc Access Source Type: research

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An analysis of central venous catheter-based hemodialysis starts
. Clin Nephrol. 2019 May 27;: Authors: Liebman SE, Chang EY Abstract Most patients in the United States initiate hemodialysis (HD) with a central venous catheter (CVC) despite a significantly increased morbidity and mortality associated with their use. Reasons for CVC-based starts have been identified, but the relative frequency of each is less clear. The aim of this retrospective chart review was to determine the most proximate cause for CVC-based HD initiations, and to determine the relative frequency of each cause. Out of 136 consec...
Source: Clinical Nephrology - Category: Urology & Nephrology Authors: Tags: Clin Nephrol Source Type: research
The Guatemalan Foundation for Children with Kidney Diseases was established in 2003 as the first and only comprehensive pediatric nephrology program and hemodialysis unit in Guatemala. Bridge of Life (BOL) is a not-for-profit charitable organization focused on chronic kidney disease and supplied equipment, training and support during formation of the hemodialysis unit. Pediatric permanent vascular access (VA) expertise had not been established and noncuffed dialysis catheters provided almost all VA, many through subclavian vein access sites.
Source: Journal of Vascular Surgery - Category: Surgery Authors: Source Type: research
This study aimed at investigating quality-of-care indicators among hemodialysis (HD) patients. This descriptive, prospective study was conducted on 144 HD patients in Zabol and Iranshahr dialysis centers from March 21 to December 22, 2015. Measurement indicators included hemoglobin level, dialysis adequacy, albumin level, vascular access, and calcium and phosphorus levels. The mean hemoglobin and dialysis adequacy level at baseline were 10.58 ± 1.6 g/dL and 1.09 ± 0.18, respectively. At the end of the study, 49.6% of participants achieved target hemoglobin level. However, only 18.6% of patients achieved targe...
Source: Saudi Journal of Kidney Diseases and Transplantation - Category: Urology & Nephrology Authors: Tags: Saudi J Kidney Dis Transpl Source Type: research
CONCLUSIONS: Compared with patients with nonoptimal starts, patients with optimal ESRD starts have lower morbidity and mortality and less use of inpatient and outpatient care. Late-stage chronic kidney disease and ESRD care in an integrated system may be associated with greater benefits than those previously reported in the literature. PMID: 30325191 [PubMed - in process]
Source: The American Journal of Managed Care - Category: Health Management Authors: Tags: Am J Manag Care Source Type: research
Authors: Gómez de la Torre-Del Carpio A, Bocanegra-Jesús A, Guinetti-Ortiz K, Mayta-Tristán P, Valdivia-Vega R Abstract OBJECTIVES: To estimate early mortality in patients with chronic kidney disease who started emergency haemodialysis between 2012 and 2014 in a national referral hospital in Lima, Peru, and to identify risk factors. DESIGN, CHARACTERISTICS, PARTICIPANTS AND MEASUREMENTS: A retrospective cohort study was conducted by reviewing the medical records of all patients admitted to the hospital's Haemodialysis Unit from 2012 to 2014. Early mortality, defined as death within the firs...
Source: Nefrologia : publicacion oficial de la Sociedad Espanola Nefrologia - Category: Urology & Nephrology Tags: Nefrologia Source Type: research
Conclusion: Females had lower odds of using AV access than do males for hemodialysis initiation. As compared to whites, blacks and Asians were more likely, and Hispanics were less likely to use AV access for first outpatient hemodialysis. Further investigation of biological and process of care factors may help in developing ways to reduce these disparities.Am J Nephrol 2018;48:4 –14
Source: American Journal of Nephrology - Category: Neurology Source Type: research
CONCLUSION: Females had lower odds of using AV access than do males for hemodialysis initiation. As compared to whites, blacks and Asians were more likely, and Hispanics were less likely to use AV access for first outpatient hemodialysis. Further investigation of biological and process of care factors may help in developing ways to reduce these disparities. PMID: 29990994 [PubMed - as supplied by publisher]
Source: American Journal of Nephrology - Category: Urology & Nephrology Authors: Tags: Am J Nephrol Source Type: research
Abstract Arteriovenous fistula is the preferred option for vascular access in hemodialysis patients. The aim of this study was to assess different follow‐up methods for hemodialysis patients in our hemodialysis center in China. A cohort of 124 patients with stage 3 chronic kidney disease was recruited and double‐blind randomly assigned into two groups. Patients in Group A received phone calls to schedule their next consultation a week in advance. Patients in Group B scheduled their next appointment at the end of each visit. A total of 116 patients were included in the study and eight dropped out. Twenty‐seven patient...
Source: Therapeutic Apheresis and Dialysis - Category: Hematology Authors: Tags: Original Article Source Type: research
Authors: Alfano G, Fontana F, Iannaccone M, Noussan P, Cappelli G Abstract Native arteriovenous fistula (AVF) is the favorite access for hemodialysis (HD). The National Kidney Foundation's Kidney Disease Outcomes Quality Initiative (KDOQI) recommends its creation in most patients with renal failure. Unfortunately, intensive efforts to promote native AVF in patients with marginal vessels have increased the rate of primary fistula failure. A non-functioning fistula prompts the use of central venous catheter (CVC) that, unlike AVF, has been associated with an increased risk of morbidity and mortality among patients re...
Source: The Journal of Vascular Access - Category: Surgery Tags: J Vasc Access Source Type: research
Conclusions The cost-effectiveness of vascular access referral is largely driven by the annual costs of HD, erythropoietin costs, and access-specific utilities. Further research is needed in the field of dialysis-related quality of life to inform decision making regarding vascular access referral.
Source: American Journal of Kidney Diseases - Category: Urology & Nephrology Source Type: research
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