Arteriovenous Fistulae for Haemodialysis: A Systematic Review and Meta-analysis of Efficacy and Safety Outcomes

Bylsma, Lauren C.; Gage, Shawn M.; Reichert, Heidi; Dahl, Shannon L. M.; Lawson, Jeffrey H.

doi:10.1016/j.ejvs.2017.06.024

Cited by 186 publications

(131 citation statements)

References 21 publications

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“…Although the time to maturation was shorter among AVG than AVF, both access types had similar rates of maturation and sustained access use. We found that 25% of AVF were abandoned without use, which is comparable to the rate of 21% described in our previously reported meta-analysis [7]. Interestingly, the median time of access use was similar between both access types, with a median of 8 months for AVF and 7 months for AVG.…”

Section: Doi: 101159/000495355supporting

confidence: 70%

“…Interestingly, the median time of access use was similar between both access types, with a median of 8 months for AVF and 7 months for AVG. Our follow-up period was not sufficient for a full analysis of patency, as the mean patency of AVF is around 28 months [7] and the median follow-up time in this cohort was 13 months (range 1-32).…”

Section: Doi: 101159/000495355mentioning

confidence: 99%

“…Rates of failure to mature have been reported between 20 and 50% [6]. Our recent systematic review and meta-analysis found that 21% of AVF were abandoned without use and only 26% were mature 6 months after placement [7]. The time from placement to use in hemodialysis is shorter among AVG than AVF, yet AVG may have higher rates of thromboses and infections over their lifespans [8].…”

Section: Introductionmentioning

confidence: 99%

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Clinical Outcomes of Arteriovenous Access in Incident Hemodialysis Patients with Medicare Coverage, 2012–2014

et al. 2019

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Background: Chronic hemodialysis requires a mode of vascular access through an arteriovenous fistula (AVF), a prosthetic arteriovenous graft (AVG), or a central venous catheter (CVC). AVF is recommended over AVG or CVC due to increased patency and decreased intervention rates for those that mature. AVG are preferred over CVC due to decreased infection and mortality risk. The aims of this study were to evaluate the lifespan of AVF and AVG in maturation, sustained access use, and abandonment. Methods: The United States Renal Data System (USRDS), Medicare claims, and CROWNWeb were used to identify access placements. Patients with a first end-stage renal disease (ESRD) service from January 1, 2012 to June 30, 2014 with continuous coverage with Medicare as primary payer and ≥1 AVF or AVG placed after ESRD onset were included. Maturation was defined as the first use of the access for hemodialysis recorded in CROWNWeb. Sustained access use was defined as 3 consecutive months of use without catheter placement or replacement. Accesses that were never used at any time post-placement were considered abandoned. Results: The cohort included 38,035 AVF placements and 12,789 AVG placements. Sixty-nine percent of AVF and 72% of AVG matured. Fifty-two percent of AVF and 51% of AVG achieved sustained access use. One quarter of AVF and 14% of AVG were abandoned without use as recorded in CROWNWeb. Conclusion: Although considered the gold standard for vascular access, only half of AVF and AVG placements achieved sustained access use. The USRDS database has inherent limitations but provides useful clinical insight into maturation, sustained use, and abandonment.

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Section: Doi: 101159/000495355supporting

confidence: 70%

Section: Doi: 101159/000495355mentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Clinical Outcomes of Arteriovenous Access in Incident Hemodialysis Patients with Medicare Coverage, 2012–2014

et al. 2019

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“…A meta-analysis reported a growing percentage of patients with non-functioning AVFs because of maturation failure in recent decades. 11 This observation might be largely a result of a change in patient demographics, with advanced age, diabetes mellitus, and nephrosclerosis as leading causes of ESRD. In these patients, calcified and noncompliant arteries and sclerotic veins might be responsible for failed vessel adaptation, resulting in low arteriovenous (AV) bloodflow and impaired vessel diameter increase.…”

Section: Introductionmentioning

confidence: 99%

Surgical and Endovascular Intervention for Dialysis Access Maturation Failure During and After Arteriovenous Fistula Surgery: Review of the Evidence

Tordoir

Zonnebeld

Loon

et al. 2018

European Journal of Vascular and Endovascular Surgery

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“…Therefore, AVF failure is also a major issue of vascular access related to the HD. A recent study demonstrated that the primary and secondary patency of AVFs at one year were only 64% and 79% [ 11], which further confirms the importance of intensive examinations for the early detection of clarifying risk factors to prevent the occurrence of AVF failure. However, to date most of the studies about the risk factors for AVF failure were still controversial [ 12,13].…”

mentioning

confidence: 79%

Framingham Risk Score and clinical outcomes of forearm autologous arteriovenous fistulas in end-stage renal disease patients: a retrospective cohort study.

Chen¹,

Liang²,

Kong³

et al. 2019

Preprint

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Background The failure of autologous arteriovenous fistulas (AVF) and cardiovascular disease (CVD) share several common risk factors. The Framingham risk score (FRS) can predict the occurrence of CVD. Accordingly, we conducted a retrospective cohort study to evaluate if the FRS can predict the AVF failure in end-stage renal disease (ESRD) patients. Methods In this study, 188 ESRD patients (with the mean age 57.2 ± 13.8 years, 64.9% of them were males) were enrolled with a median follow-up time of 41 months. AVF failure was defined as the presence of stenosis or thrombosis, and loss of the ability to receive prescribed hemodialysis. Primary patency of AVFs, and the association between FRS and AVF failure or death were analyzed by the Kaplan-Meier method or Cox proportional hazards model, accordingly. Results The primary patency of AVFs was 84.6%, 79.3%, 76.6%, 76.1% and 76.1% at 12, 24, 36, 48 and 60 months, respectively. However, there was no significant difference of the primary patencies among the 1st Quartile, 2nd Quartile, 3rd Quartile and 4th Quartile of FRS (log-rank test, p =0.15). Moreover, FRS was not associated with all-cause or CVD mortality after adjusting for other confounders in the Cox proportional hazards models. Conclusions This study did not find FRS associated with AVF failure or mortality among ESRD patients.

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Arteriovenous Fistulae for Haemodialysis: A Systematic Review and Meta-analysis of Efficacy and Safety Outcomes

Cited by 186 publications

References 21 publications

Clinical Outcomes of Arteriovenous Access in Incident Hemodialysis Patients with Medicare Coverage, 2012–2014

Clinical Outcomes of Arteriovenous Access in Incident Hemodialysis Patients with Medicare Coverage, 2012–2014

Surgical and Endovascular Intervention for Dialysis Access Maturation Failure During and After Arteriovenous Fistula Surgery: Review of the Evidence

Framingham Risk Score and clinical outcomes of forearm autologous arteriovenous fistulas in end-stage renal disease patients: a retrospective cohort study.

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