Are continued policies of prioritizing native vascular access in patients on hemodialysis programs useful?
Ibáñez Pallarès, Sara ![ORCID Identifier](/img/uab/orcid.ico)
(Hospital Universitari MútuaTerrassa (Terrassa, Catalunya))
Esteve Simó, Vicent ![ORCID Identifier](/img/uab/orcid.ico)
(Hospital Universitari MútuaTerrassa (Terrassa, Catalunya))
Velescu, Alina (Hospital del Mar (Barcelona, Catalunya))
Tapia González, Irati ![ORCID Identifier](/img/uab/orcid.ico)
(Universitat Autònoma de Barcelona. Departament de Medicina)
Collado, S ![ORCID Identifier](/img/uab/orcid.ico)
(Hospital del Mar (Barcelona, Catalunya))
Clará Velasco, Alberto (Hospital del Mar (Barcelona, Catalunya))
Date: |
2022 |
Abstract: |
The guidelines recommend establishing native vascular access as opposed to prosthetic or catheter-based access despite information relating to its effectiveness being scarce from a patient-orientated perspective. We analyzed the effectiveness of a continued policy of native vascular access (CPNVA) in patients undergoing hemodialysis. A retrospective, observational study, including 150 patients undergoing hemodialysis between 2006 and 2012 at our center, and who underwent a CPNVA. Statistical analysis was based on treatment intention. In 138 patients (92%), the first useful access (FUA) was native, and in 12 patients (8%), it was prosthetic. In 50 patients (33. 3%), more than one procedure had to be carried out in to order to achieve FUA. The probability of dialysis occurring via a FUA was 67. 1% and 45. 3% at 1 and 5 years respectively. Over the follow-up period (mean time = 30 months), 84 patients (56%) required repairs or new access, extending the effectiveness of the CPNVA to 88. 3% and 73. 2% at 1 and 5 years respectively. The effectiveness of the CPNVA was reduced if the patient: required a catheter initially (HR: 3. 6, p = 0. 007); in cases of initially elevated glomerular filtration rate (HR: 1. 1, p = 0. 040); in cases of history of previous access failure before FUA (HR: 3. 9, p = 0. 001); and in female patients (HR: 2. 4, p = 0. 031). The long-term effectiveness of a CPNVA is high. However, the percentage of patients requiring diverse procedures in order to achieve FUA and the need for re-interventions yield the necessity to optimize preoperative evaluation and postoperative follow-up. |
Note: |
Altres ajuts: acords transformatius de la UAB |
Rights: |
Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, i la comunicació pública de l'obra, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original. No es permet la creació d'obres derivades. ![Creative Commons](/img/licenses/by-nc-nd.ico) |
Language: |
Anglès |
Document: |
Article ; recerca ; Versió publicada |
Subject: |
AV access ;
Dialysis ;
Follow-up ;
Native vascular access ;
Patient-orientated ;
Survival |
Published in: |
Therapeutic Apheresis and Dialysis, Vol 26 (2022) , p. 434-440, ISSN 1744-9987 |
DOI: 10.1111/1744-9987.13711
PMID: 34296527
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Record created 2021-09-08, last modified 2023-04-01