Long‐term effects of daily hemodialysis on vascular access outcomes: A prospective controlled study

Achinger, Steven G.; İkizler, T. Alp; Bian, Aihua; Shintani, Ayumi; Ayus, Juan Carlos

doi:10.1111/j.1542-4758.2012.00756.x

Cited by 13 publications

(7 citation statements)

References 32 publications

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“…Achinger et al demonstrated no change in vascular access adverse event rate with extended‐hours compared to conventional hemodialysis (incident rate ratio 0.74, 95% CI 0.40 to 1.36, P = 0.33) . Vascular access events were reported for a further non‐randomized trial, however data were unable to be synthesized.…”

Section: Resultsmentioning

confidence: 98%

The effect of extended‐hours hemodialysis on outcomes: A systematic review and meta‐analysis

Hull

March

Churchward

et al. 2020

Hemodialysis International

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Extended-hours hemodialysis is associated with improvements in quality of life (QoL) and mortality, but it may accelerate the loss of residual kidney function (RKF) and increase vascular access complications. Multiple established databases were systematically searched; randomized and nonrandomized studies were pooled separately. QoL outcomes were assessed using standardized mean difference (SMD), vascular access adverse events and mortality were assessed with relative risk ratios (RR). Four hundred seventy-six patients from six trials were eligible. Data from randomized controlled trials (RCTs) could only be synthesized for vascular access adverse events and mortality, which demonstrated no significant change in vascular access adverse events (RR 1.25, 95% CI 0.88 to 1.77) or mortality (RR 2.29, 95% CI 0.60 to 8.71). Pooled data from non-randomized trials demonstrated no significant difference in QoL (SF-36 Physical Component Summary SMD 0.61, 95% CI −0.10 to 1.31, SF-36 Mental Component Summary SMD −0.04, 95% CI −0.61 to 0.54). RKF was assessed in one report which demonstrated a potential reduction over 12 months with extendedhours hemodialysis. The majority of trials had high risk of bias. Extended-hours hemodialysis was not associated with improved QoL or mortality, or increased vascular access events. Adequately powered RCTs are needed to fully assess extended-hours hemodialysis.

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Section: Resultsmentioning

confidence: 98%

The effect of extended‐hours hemodialysis on outcomes: A systematic review and meta‐analysis

Hull

March

Churchward

et al. 2020

Hemodialysis International

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“…Nineteen studies met the inclusion criteria [4,5,7,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25]. Three studies were excluded because the vascular access event rates were not reported [26,27] or because of missing demographic data [28].…”

Section: Resultsmentioning

confidence: 99%

Vascular Access Vulnerability in Intensive Hemodialysis: A Significant Achilles' Heel?

Cornelis¹,

Usvyat

Tordoir

et al. 2014

Blood Purif

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Background: Frequent hemodialysis (HD) may be associated with an increased risk of vascular access complications. Studies addressing vascular access outcomes in frequent HD show conflicting results. Methods: We searched Medline for trials looking at vascular access outcomes in frequent HD. Results: Nineteen studies met the inclusion criteria; only studies with a control group were included for analysis (n = 15). The vascular access event rate was higher in intensive HD as compared to conventional HD (difference of 6.7 events per 100 patient-years, p = 0.009). Overall event rates were not significantly different between conventional and intensive HD when stratified for access type, but were notably higher in the arteriovenous grafts and catheter group as compared to the arteriovenous fistula (AVF) group. Conclusion: Intensive HD is associated with an increased risk of vascular access complications. Overall reported event rates were lower in the AVF group. Further controlled studies should investigate whether a ‘fistula first' strategy may be recommended also for intensive HD.

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“…La durée moyenne de la formation était de 35 jours (35)(36)(37)(38)(39)(40)(41)(42). Dix patients (83%) ont été installés à domicile.…”

Section: Programme De La Formation Des Patientsunclassified

Early results and medico-economic evaluation of a short daily home hemodialysis program in a Private hemodialysis center

Hebibi¹,

Ciroldi²,

Cornillac³

et al. 2021

Bull Dial Domic

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Between 2015 and 2017 there was a 40% increase in daily hemodialysis, according to the REIN database. This increase concerns 1% of patients and the private sector remains under-represented. Our retrospective study aims to describe the clinical features, the organizational and medico-economic specificities of this technique in a private hemodialysis center. Methods: We included 12 dialyzed patients trained on Nx Stage® machine from February 2020 to April 2021. Data were retrospectively obtained through review of our electronic medical records (EUCLID®). Results: Of the 12 patients trained, 11 dialyzed from home, with an average follow-up of 9 months (1-14). The average age was 45 with a sex ratio of 4/8 (M/W), and a median Charlson score of 3 (2-4). The average residual urinary output was 700 mL/24h, and 50% of patients were anuric. 100% of patients had an arteriovenous fistula and were cannulated using the buttonhole technique. 9 patients are on a transplant list. One patient needed anticoagulants. The mean training time was 35 days (28-35). 83% of patients were dialyzed 6 days a week with an average duration of 210 minutes (130-150) per session. The average volume of dialysate was 24.85 liters. One patient developed an allergy to the PUREMA® membrane. Pre-dialytic hemoglobin, serum creatinine, urea, phosphoremia and B2-microglobuline are stable at 9 months with improvement in metabolic acidosis. Conclusion: DHHD allowed a better socio-professional integration. One patient received a transplant and 3 patients resumed professional activity.

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Long‐term effects of daily hemodialysis on vascular access outcomes: A prospective controlled study

Cited by 13 publications

References 32 publications

The effect of extended‐hours hemodialysis on outcomes: A systematic review and meta‐analysis

The effect of extended‐hours hemodialysis on outcomes: A systematic review and meta‐analysis

Vascular Access Vulnerability in Intensive Hemodialysis: A Significant Achilles' Heel?

Early results and medico-economic evaluation of a short daily home hemodialysis program in a Private hemodialysis center

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