Venous access: Women are equal

Caplin, Nina J.; Sedlacek, Martin; Teodorescu, Victoria; Falk, Abigail; Uribarri, Jaime

doi:10.1053/ajkd.2003.50052

Cited by 77 publications

(59 citation statements)

References 16 publications

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“…Moreover, Caplin et al (26) reported equal AVF success rates and prevalence in both women and men. In their center, preoperative vascular mapping was routinely performed using duplex ultrasound.…”

Section: Discussionmentioning

confidence: 99%

Comorbidities Do not Influence Primary Fistula Success in Incident Hemodialysis Patients

Wang¹,

Murphy²,

Yılmaz³

et al. 2008

Clinical Journal of the American Society of Nephrology

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Background and objectives: Concern about primary fistula failure may contribute to the underuse of arteriovenous fistula. The objective of this study was to investigate the baseline clinical parameters associated with primary fistula success.Design, setting, participants, & measurements: Consecutive incident patients who commenced dialysis during a 28-mo period in a regional renal program were studied. Data on patient-related variables and on surgical approach (e.g., whether the surgeons routinely assess vessel size during the operation) were collected. Primary fistula success was defined as an arteriovenous fistula that was able to afford successful dialysis for 3 h with blood pump speed of >300 ml/min for three consecutive sessions.Results: A total of 205 (69%) patients had an AVF attempted as their first vascular access. The overall primary success rate was 64% and was similar for radiocephalic and brachiocephalic fistula. Logistic regression was done separately for patients with the two types of fistula because of the presence of statistical interaction. For radiocephalic fistula, male gender was the only parameter associated with primary fistula success (odds ratio 3.57; P ‫؍‬ 0.01). The presence of comorbidity was not significantly associated with primary fistula failure.Conclusions: Despite significant patient comorbidity, there was a high primary fistula success rate among this incident hemodialysis cohort. Given that vessel size may be the ultimate determinant of fistula success, if surgeons assess vessel size perioperatively, then the presence of significant comorbidity might not preclude arteriovenous fistula from being attempted as the initial access.

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Section: Discussionmentioning

confidence: 99%

Comorbidities Do not Influence Primary Fistula Success in Incident Hemodialysis Patients

Wang¹,

Murphy²,

Yılmaz³

et al. 2008

Clinical Journal of the American Society of Nephrology

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“…Several studies report that females are more likely to use an AVG or central venous catheter than an AVF [11,12,19,20]. Vein caliber does not appear to differ by gender, and in two single-center studies, there was no gender difference in the likelihood of pre-ESRD vascular access placement [21,22]. However, females with an AVF experience a greater number of early vascular access-related procedures presumably to promote AVF maturation, and may experience poorer AVF maturation and AVF dysfunction [19,22,23,24,25].…”

Section: Discussionmentioning

confidence: 99%

Racial and Gender Differences in Arteriovenous Fistula Use among Incident Hemodialysis Patients

Wasse¹,

Hopson

McClellan³

2010

Am J Nephrol

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Background: Arteriovenous fistula (AVF) use is reported to differ among racial and gender groups. We sought to identify risk factors associated with incident AVF and whether racial and gender differences in AVF use persist after controlling for these factors. Methods: We evaluated 28,712 incident adult hemodialysis patients (age ≧18) from five ESRD networks starting dialysis between June 1, 2005 and May 31, 2006. Data were obtained from the Center for Medicaid and Medicare Services 2728 form. Results: Incident AVF use was reported for 11% of black and 12% of white patients [OR = 0.89 (95% CI: 0.83, 0.96)], and for 9% of females and 13% of males [OR = 0.66 (0.62–0.71)]. After adjusting for facility clustering, blacks were as likely as whites to use an AVF [OR = 1.00 (0.92–1.09)], while gender differences persisted [OR = 0.64 (0.59–0.69)]. Compared to patients with no renal care prior to dialysis initiation, incident AVF use was 16-fold greater among those with ≧12 months of nephrology care [OR = 15.99 (13.25–19.29)], 9-fold greater among those with 6–12 months of care [OR = 9.00 (7.45–10.88)] and 7-fold greater among those with at least 6 months of care [OR = 7.13 (5.73–8.88)]. Conclusion: Racial, but not gender, differences in incident AVF use were eliminated after accounting for clustering within facilities.

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“…A traditional fear of smaller vessels in women may have prevented some nephrologists from considering AVF in female patients. However, published data using duplex Doppler ultrasonography have demonstrated that vessel diameter does not differ among sexes [117] . Likely, surgical training is the key to both fistula placement and survival, as recent studies, almost a decade after the original observations, do not observe sex differences in AVF failure, perhaps reflecting an improvement in both technique and physician experience [118,119] .…”

Section: Gender Differences In Dialysis Therapy Adequacy and Patientmentioning

confidence: 93%

Gender Differences in Chronic Kidney Disease: Underpinnings and Therapeutic Implications

Carrero

2010

Kidney Blood Press Res

126

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In nephrology, gender differences exist with regard to the epidemiology, evolution and prognosis of chronic kidney disease (CKD). In some cases, these differences run contrary to the general population trends. This review discusses such gender and sex disparities, including differing impact of traditional and novel risk factors, prescription patterns, differences in the responses to therapies, as well as hormonal factors, all of them potentially influencing propensity, progression and biochemical and psychological aspects of CKD. Through the integration of gender aspects in CKD research and management, we may be able not only to identify novel therapeutic targets but also improve existing treatment options.

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Venous access: Women are equal

Cited by 77 publications

References 16 publications

Comorbidities Do not Influence Primary Fistula Success in Incident Hemodialysis Patients

Comorbidities Do not Influence Primary Fistula Success in Incident Hemodialysis Patients

Racial and Gender Differences in Arteriovenous Fistula Use among Incident Hemodialysis Patients

Gender Differences in Chronic Kidney Disease: Underpinnings and Therapeutic Implications

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