Detailed Information

Cited 0 time in webofscience Cited 0 time in scopus
Metadata Downloads

Vascular access placement and mortality in elderly incident hemodialysis patients

Authors
Ko, Gang JeeRhee, Connie M.Obi, YoshitsuguChang, Tae IkSoohoo, MelissaKim, Tae WooKovesdy, Csaba P.Streja, ElaniKalantar-Zadeh, Kamyar
Issue Date
3월-2020
Publisher
OXFORD UNIV PRESS
Keywords
elderly; hemodialysis; mortality; tunneled dialysis catheter; vascular access
Citation
NEPHROLOGY DIALYSIS TRANSPLANTATION, v.35, no.3, pp.503 - 511
Indexed
SCIE
SCOPUS
Journal Title
NEPHROLOGY DIALYSIS TRANSPLANTATION
Volume
35
Number
3
Start Page
503
End Page
511
URI
https://scholar.korea.ac.kr/handle/2021.sw.korea/57513
DOI
10.1093/ndt/gfy254
ISSN
0931-0509
Abstract
Background. Arteriovenous fistulas (AVFs) are the preferred vascular access type in most hemodialysis patients. However, the optimal vascular access type in octogenarians and older (>= 80years) hemodialysis patients remains widely debated given their limited life expectancy and lower AVF maturation rates. Methods. Among incident hemodialysis patients receiving care in a large national dialysis organization during 2007-2011, we examined patterns of vascular access type conversion in 1 year following dialysis initiation in patients <80 versus >= 80 years of age. Among a subcohort of patients >= 80years of age, we examined the association between vascular access type conversion and mortality using multivariable survival models. Results. In the overall cohort of 100804 patients, the prevalence of AVF/arteriovenous graft (AVG) as the primary vascular access type increased during the first year of hemodialysis, but plateaued thereafter. Among 8356 patients >= 80years of age and treated for >1 year, those with initial AVF/AVG use and placement of AVF from a central venous catheter (CVC) had lower mortality compared with patients with persistent CVC use. When the reference group was changed to patients who had AVF placement from a CVC in the first year of dialysis, those with initial AVF use had similar mortality. A longer duration of CVC use was associated with incrementally worse survival. Conclusions. Among incident hemodialysis patients >= 80years of age, placement of an AVF from a CVC within the first year of dialysis had similar mortality compared with initial AVF use. Our data suggest that initial CVC use with later placement of an AVF may be an acceptable option among elderly hemodialysis patients.
Files in This Item
There are no files associated with this item.
Appears in
Collections
College of Medicine > Department of Medical Science > 1. Journal Articles

qrcode

Items in ScholarWorks are protected by copyright, with all rights reserved, unless otherwise indicated.

Related Researcher

Researcher Ko, Gang Jee photo

Ko, Gang Jee
의과대학 (의학과)
Read more

Altmetrics

Total Views & Downloads

BROWSE