Influence of vascular access type on outcome measures in patients on maintenance hemodialysis

Deepa H. Chand, Boon Wee Teo, Richard A. Fatica, Michael Brier

Research output: Contribution to journalArticle

17 Scopus citations

Abstract

Background: Previous studies postulate that end-stage renal disease (ESRD) patients dialyzed with central venous catheters (CVC) have poorer outcomes compared to patients using arteriovenous fistulae (AVF) or arteriovenous grafts (AVG). Clinical practice guidelines should obviate these differences if access was not important. This study compared clinical measures of adequacy, anemia, and nutrition/inflammation in prevalent hemodialysis patients in 2003 by access type. Methods: Data from The Renal Network Data System were analyzed by univariate analysis of variance to compare Kt/V, URR, albumin, hemoglobin (Hb) and recombinant human erythropoietin (EPO) dose by access type, while adjusting for pertinent factors. Results: 12,501 patients were included. The access type distribution was AVF 36%, AVG 41%, and CVC 23%. CVC patients had lower mean URR, Kt/V, albumin concentration (p < 0.001) than other accesses. Serum Hbs were similar (p = 0.416), however EPO dose (U/kg/week) was higher in those dialyzed with CVC compared to AVF/AVG (p < 0.001). Conclusions: Despite practice guidelines, patients dialyzed via CVC have poorer outcome measures compared to other accesses. This suggests that AVF should be used and/or appropriate adjustments need to be made for those dialyzed with CVC to achieve equal outcomes. Further studies defining barriers need to be conducted.

Original languageEnglish
Pages (from-to)c91-c98
JournalNephron - Clinical Practice
Volume108
Issue number2
DOIs
StatePublished - Mar 1 2008
Externally publishedYes

Keywords

  • Arteriovenous fistula
  • Central venous catheter
  • Hemodialysis
  • Vascular access

Fingerprint Dive into the research topics of 'Influence of vascular access type on outcome measures in patients on maintenance hemodialysis'. Together they form a unique fingerprint.

  • Cite this