Comparison of Temporary Dialysis Catheter and A-V Fistula Use at the Time of Starting Chronic Hemodialysis among End-Stage Renal Diseases Patients

Document Type : Research Paper

Authors

1 Assistant Professor of Nephrology, Jundishapur University of Medical Sciences, Ahvaz, Iran

2 Assistant Professor Of Surgery, Jundishapur University of Medical Sciences, Ahvaz, Iran

3 Assistant Professor Of Nephrology, Mashhad University of Medical Sciences, Mashhad, Iran

Abstract

Introduction
The preferred type of access for chronic hemodialysis (HD) is an Arterio-Venous (A-V) Fistula. However most of the ESRD patients does not have a mature fistula at the time of starting HD due to late referral to the nephrologists so the managing physicians have to use temporary catheters with high rate of complications.
Materials and Methods
In a retrospective study we determined and compared the prevalence of temporary catheters or A-VFistula use at the time of starting chronic HD from November 1995 to June 2009. We have divided our patients in three different groups. Group A: HD patients between 1995-2005, Group B: HD patients between 2006-2007, and Group C: HD patients after 2007.
Results
A total of 473 ESRD patients (288 male, 185 female; mean age, 55.8± 16.4 years) were included in the study. Causes of ESRD were HTN 34.1%, DM 20. 08%, glomeronephritis 9.72%, obstructive uropathy 8.46%, ADPKD 5.92%, and unknown 21.77%. Overall the prevalence of temporary catheters and A-V Fistula use were 86.5 and 13.5 percent. But the prevalence was different in the studied groups: group A (93.6% and 6.4%), in group B (85.0% and 15.0%) and in group C (67.5% and 29. 5%) respectively. There was a significant increase in A-V Fistula use after 2005 (p=0.00) and especially after 2007 (p=0.000).
Conclusion
Although there was a significant increment in the A-V Fistula use, it is not still enough and general physicians, nurses and chronic kidney disease patients have to be educated about the benefits of early A-V Fistula creation.

Keywords

References

1- USRDS: The United States Renal Data System. Excerpts from the USRDS 2008 annual data report: Atlas of endstage
renal disease in the United States. Am J Kidney Dis 2009; 1:S1.
2- Beladi Musavi SS, Hayati F, Alemzadeh Ansari MJ, Valavi E, Cheraghian B, Shahbazian H, et al. Survival at 1, 3,
and 5 Years in Diabetic and Nondiabetic Hemodialysis Patients. Iran J Kidney Dis 2010; 4:74-77.
3- Nafar M, Monsavi SM , Mhdavi M , Pour-Reza-Gholi F, Firoozan A, Einollahi B , et al . Burden of Chronic
Kidney in Iran. Iran J Kidney Dis 2008; 2:138-192.
4- Fan PY. Acute vascular access: New advances. Adv Ren Replace Ther 1994; 1:90.
Vanholder R, Lameiere, N, Verbanck J, van Rattinghe R, Kunnen M, Ringoir S.
5-Complications of subclavian catheters for hemodialysis: A 5 year prospective study in 257 consecutive patients. Int J
Artif Organs 1982; 5:297.
6- Lok, CE, Oliver, MJ. Overcoming barriers to arteriovenous fistula creation and use. Semin Dial 2003; 16:189.
Asif A, Cherla G, Merrill D, Cipleu CD, Briones P, Pennell P.
7- Conversion of tunneled hemodialysis catheter-consigned patients to arteriovenous fistula. Kidney Int 2005; 67:2399.
8- Polo JR, Tejedor A, Polo J, Sanabia J, Calleja J, Gó mez F. Long-term follow-up of 6-8 mm brachioaxillary
polytetrafluorethylene grafts for hemodialysis. Artif Organs 1995; 19:1181.
9- Saad TF. Bacteremia associated with tunneled, cuffed hemodialysis catheters. Am J Kidney Dis 1999; 34:1114.
10- Bender MH, Bruyninckx CM, Gerlag PG. The brachiocephalic elbow fistula: a useful alternative angioaccess for
permanent hemodialysis. J Vasc Surg 1994; 20:808.
11- Coburn MC, Carney WI Jr. Comparison of basilic vein and polytetrafluoroethylene for brachial arteriovenous
fistula. J Vasc Surg 1994; 20:896.
12-Rodriguez JA, Armadans L, Ferrer E, Olmos A, Codina S, Bartolomé J ,et al. The function of permanent vascular
access. Nephrol Dial Transplant 2000; 15:402.
13- Vascular access use in Europe and the United States: Results from the DOPPS. Kidney Int 2002; 61: 305–316.
14- Ethier J, Mendelssohn DC, Elder SJ, Hasegawa T, Akizawa T, Akiba T, et al. Vascular access use and outcomes:
an international perspective from the dialysis outcomes and practice patterns study. Nephrol Dial Transplant 2008;
23:3219-32 26.
15- Cruz JM, Piera L, Bragg-Gresham JL, Feldman H, Port FK. Results of the international hemodialysis study DOPPS
in Spain and Europe. Nefrologia 2003; 23:437-443.
16- Fan PY. Acute vascular access: New advances. Adv Ren Replace Ther 1994; 1:90.
17- Sottiurai VS, Stephens A, Champagne L, Moradeshagi P, Frey D, Reisin E. Comparative results of early and
delayed cannulation of arteriovenous graft in haemodialysis. Eur J Vasc Endovasc Surg 1997; 13:139.
18- Rayner HC, Pisoni RL, Gillespie BW, Goodkin DA. Creation, cannulation and survival of arteriovenous fistulae:
Data from the Dialysis Outcomes and Practice Patterns Study. Kidney Int 2003; 63:323.
19- Saran R, Dykstra DM, Pisoni RL, Akiba T, Akizawa T, Canaud B, et al. Timing of first cannulation and vascular
access failure in haemodialysis: an analysis of practice patterns at dialysis facilities in the DOPPS. Nephrol Dial
Transplant 2004; 19:2334.
20- Oliver MJ, Rothwell DM, Fung K, Hux JE, Lok CE. Late creation of vascular access for hemodialysis and
increased risk of sepsis. J Am Soc Nephrol 2004; 15:1936
medical journal of mashhad university of medical sciences
Volume 54, Issue 2 - Serial Number 2
May and June 2010
Pages 75-79

Files

Share

How to cite

Statistics