Qisu Ying1, Yong Mao2, Xiangcheng Xie1, Ping Wu3, Jilin Ma4, Wei Zhou5, Jinhua Xu6, Xiao Fei1, Ming Wang1, Yingying Qian1, Jiayu Shao1, Xiaofeng Xia1, Xiu Yang1. 1. Department of Nephrology, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, China. 2. Department of Pharmacy, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, China. 3. Department of Nephrology, The Affiliated Hospital of Hangzhou Normal University (Hangzhou Second People's Hospital), Hangzhou, China. 4. Department of Nephrology, Hangzhou Red Cross Hospital, Hangzhou, China. 5. Department of Nephrology, The First People's Hospital of Hangzhou Lin'an District, Hangzhou, China. 6. Department of Nephrology, The First People's Hospital of Fuyang Hangzhou, Hangzhou, China.
Abstract
OBJECTIVE: To investigate the initial hemodialysis vascular access in Hangzhou and provide evidence for improving the use of autologous arteriovenous fistula by identifying factors associated with the choice of initial vascular access. METHODS: We retrospectively studied the initial hemodialysis vascular access of 257 patients in five hemodialysis units in Hangzhou of China during a 21-month period (January 2018 to September 2019). A logistic regression was used to identify the risk factors of failing to use an arteriovenous fistula at the initiation of hemodialysis. RESULTS: (1) 257 participants with mean age 67.65 ± 13.43 years old were reviewed, including 165 males (64.2%) and 92 females (35.8%). The etiologies of end-stage renal disease included diabetic nephropathy (37.35%), chronic glomerulonephritis (31.13%), hypertensive nephropathy (14.01%), and other diseases (17.51%). Only 51 patients (19.84%) received arteriovenous fistula, whereas the remaining 206 patients (80.16%) initiated dialysis with a central venous catheter. (2) Logistic regression analysis revealed that the independent risk factors for central venous catheter at the initial hemodialysis were age >70 years old (OR = 4.827, p < 0.01 versus ≤70 years old), chronic glomerulonephritis as the primary etiology (OR = 2.565, p < 0.05 versus nonchronic glomerulonephritis) and eGFR <8.5 mL/min/1.73m2 (OR = 2.283, p < 0.05 versus eGFR ≥8.5 mL/min/1.73m2). CONCLUSION: The proportion of patients using arteriovenous fistula as the initial hemodialysis vascular access in Hangzhou was still low. The choice of vascular access for the first hemodialysis was related to age, eGFR, and the primary etiology of end-stage renal disease. Increasing the proportion of planned vascular access and arteriovenous fistula at the initiation of hemodialysis is still our current goal.
OBJECTIVE: To investigate the initial hemodialysis vascular access in Hangzhou and provide evidence for improving the use of autologous arteriovenous fistula by identifying factors associated with the choice of initial vascular access. METHODS: We retrospectively studied the initial hemodialysis vascular access of 257 patients in five hemodialysis units in Hangzhou of China during a 21-month period (January 2018 to September 2019). A logistic regression was used to identify the risk factors of failing to use an arteriovenous fistula at the initiation of hemodialysis. RESULTS: (1) 257 participants with mean age 67.65 ± 13.43 years old were reviewed, including 165 males (64.2%) and 92 females (35.8%). The etiologies of end-stage renal disease included diabetic nephropathy (37.35%), chronic glomerulonephritis (31.13%), hypertensive nephropathy (14.01%), and other diseases (17.51%). Only 51 patients (19.84%) received arteriovenous fistula, whereas the remaining 206 patients (80.16%) initiated dialysis with a central venous catheter. (2) Logistic regression analysis revealed that the independent risk factors for central venous catheter at the initial hemodialysis were age >70 years old (OR = 4.827, p < 0.01 versus ≤70 years old), chronic glomerulonephritis as the primary etiology (OR = 2.565, p < 0.05 versus nonchronic glomerulonephritis) and eGFR <8.5 mL/min/1.73m2 (OR = 2.283, p < 0.05 versus eGFR ≥8.5 mL/min/1.73m2). CONCLUSION: The proportion of patients using arteriovenous fistula as the initial hemodialysis vascular access in Hangzhou was still low. The choice of vascular access for the first hemodialysis was related to age, eGFR, and the primary etiology of end-stage renal disease. Increasing the proportion of planned vascular access and arteriovenous fistula at the initiation of hemodialysis is still our current goal.
Authors: Charmaine E Lok; Thomas S Huber; Timmy Lee; Surendra Shenoy; Alexander S Yevzlin; Kenneth Abreo; Michael Allon; Arif Asif; Brad C Astor; Marc H Glickman; Janet Graham; Louise M Moist; Dheeraj K Rajan; Cynthia Roberts; Tushar J Vachharajani; Rudolph P Valentini Journal: Am J Kidney Dis Date: 2020-03-12 Impact factor: 8.860
Authors: A Gomis Couto; J L Teruel Briones; M Fernández Lucas; M Rivera Gorrin; N Rodríguez Mendiola; S Jiménez Álvaro; C Quereda Rodríguez-Navarro Journal: Nefrologia Date: 2011 Impact factor: 2.033