Vascular access‐related mortality in hemodialysis patients during and after hospitalization

Abstract

Long‐term prognosis is poorer in hemodialysis patients wearing a permanent catheter than in those with a fistula; however, few data are available regarding the survival of hospitalized patients according to their vascular access. The aim of the present study is to analyze the influence of vascular access in the prognosis of hemodialysis patients during hospitalization. A prospective observational study was conducted, including 100 consecutive hemodialysis patients that were hospitalized for any cause. At baseline, we collected epidemiological data, comorbidities, and variables related to the hospitalization (analytical values, reason for admission, and type of vascular access). We divided the whole sample into two groups regarding the vascular access (fistula or catheter), and compared associated variables and short‐term survival. We analyzed mortality during hospitalization and during follow‐up. Of the 100 patients studied, 71 (71%) were male, with a mean age of 71 ± 12 years. Fifty patients (50%) had fistulae as vascular access. Mean dialysis vintage was 60 ± 47 months. Eighteen patients (18%) died during the hospitalization and 27 (27%) at the end of the follow‐up (median 144 [47‐269] months). Variables associated to survival during hospitalization were vascular access, personal history of heart failure, dialysis vintage, and analytical values at admission such as low hemoglobin, high lactic acid, and low albumin. A regression model demonstrated that vascular access was an independent predictor of survival during hospitalization and, also, during the follow‐up. Permanent catheters should be avoided as they are independent predictors of mortality in hospitalized hemodialysis patients.

Primary hyperoxaluria type 1 in children: Clinical classification, renal replacement therapy, and outcome in a single centre experience

“…These data are consistent with previous results [4,20]. Similarly, it was recently reported by Giraldo and his colleagues that using catheter as vascular access in HD patients is associated with increased risk of mortality of patients, which is independent of other variables such as age or comorbidities [21]. Surprisingly, we reported less infection rate ( p = 0.0216) among our HD PH1 patients than controls.…”

Arterial Calcifications and Osteoprotegerin in Chronic Hemodialysis Patients – Impact on 6 Years Survival

“…We obtained other important results related to impact on outcome. Our patients with no AVF, using a central venous catheter as the vascular access for HD had an elevated all-cause and cardiovascular mortality; this is a result consistent some studies 28 , but not with others 29 . Best survival belonged to patients with AVF.…”

Comparison of functional patency rates between paclitaxel‐eluting versus plain balloon angioplasty in hemodialysis patients with central venous stenosis: An intra‐individual comparison study

“…Maintaining fistula patency in patients with CVS is a common problem, and repeated balloon angioplasties are the first choice of treatment. Consequently, early treatment of central vein stenosis will prolong the patency of AV access and protect from the central venous catheter that increase the mortality of patients [9]. Unfortunately, medium‐ to long‐term patency rates after balloon dilatations are limited.…”