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Type of arteriovenous vascular access and association with patency and mortality

BACKGROUND: There are only a few risk factors known for primary patency loss in patients with an arteriovenous graft or fistula. Furthermore, a limited number of studies have investigated the association between arteriovenous access modality and primary patency loss and mortality. The aim of this st...

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Autores principales: Ocak, Gürbey, Rotmans, Joris I, Vossen, Carla Y, Rosendaal, Frits R, Krediet, Raymond T, Boeschoten, Elisabeth W, Dekker, Friedo W, Verduijn, Marion
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3621613/
https://www.ncbi.nlm.nih.gov/pubmed/23557085
http://dx.doi.org/10.1186/1471-2369-14-79
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author Ocak, Gürbey
Rotmans, Joris I
Vossen, Carla Y
Rosendaal, Frits R
Krediet, Raymond T
Boeschoten, Elisabeth W
Dekker, Friedo W
Verduijn, Marion
author_facet Ocak, Gürbey
Rotmans, Joris I
Vossen, Carla Y
Rosendaal, Frits R
Krediet, Raymond T
Boeschoten, Elisabeth W
Dekker, Friedo W
Verduijn, Marion
author_sort Ocak, Gürbey
collection PubMed
description BACKGROUND: There are only a few risk factors known for primary patency loss in patients with an arteriovenous graft or fistula. Furthermore, a limited number of studies have investigated the association between arteriovenous access modality and primary patency loss and mortality. The aim of this study was to investigate risk factors for patency loss and to investigate the association between graft versus fistula use and outcomes (patency loss and mortality). METHODS: We prospectively followed 919 incident hemodialysis patients and calculated hazard ratios (HRs) for putative risk factors of primary patency loss using Cox regression. Furthermore, HRs were calculated to study the association between graft versus fistula use and two-year primary patency loss and two-year mortality. RESULTS: Cardiovascular disease, prior catheter use, lowest tertile of albumin, highest tertile of hsCRP, and lowest tertile of fetuin-A were associated with primary patency loss in both patients with grafts and fistulas. Increased age, female sex, and diabetes mellitus were only associated with primary patency loss in patients with a fistula. We did not observe an association between primary patency loss and BMI, residual GFR, levels of calcium, phosphorus, and total cholesterol. Furthermore, graft use as compared with fistula use was associated with an 1.4-fold (95% CI 1.0-1.9) increased risk of primary patency loss and with an 1.5-fold(95% CI 1.0-2.2) increased mortality risk. CONCLUSION: Cardiovascular disease, prior catheter use, albumin, hsCRP, and fetuin-A are risk factors for patency loss. Graft use as compared with fistula use was associated with an increased risk of patency loss and mortality.
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spelling pubmed-36216132013-04-10 Type of arteriovenous vascular access and association with patency and mortality Ocak, Gürbey Rotmans, Joris I Vossen, Carla Y Rosendaal, Frits R Krediet, Raymond T Boeschoten, Elisabeth W Dekker, Friedo W Verduijn, Marion BMC Nephrol Research Article BACKGROUND: There are only a few risk factors known for primary patency loss in patients with an arteriovenous graft or fistula. Furthermore, a limited number of studies have investigated the association between arteriovenous access modality and primary patency loss and mortality. The aim of this study was to investigate risk factors for patency loss and to investigate the association between graft versus fistula use and outcomes (patency loss and mortality). METHODS: We prospectively followed 919 incident hemodialysis patients and calculated hazard ratios (HRs) for putative risk factors of primary patency loss using Cox regression. Furthermore, HRs were calculated to study the association between graft versus fistula use and two-year primary patency loss and two-year mortality. RESULTS: Cardiovascular disease, prior catheter use, lowest tertile of albumin, highest tertile of hsCRP, and lowest tertile of fetuin-A were associated with primary patency loss in both patients with grafts and fistulas. Increased age, female sex, and diabetes mellitus were only associated with primary patency loss in patients with a fistula. We did not observe an association between primary patency loss and BMI, residual GFR, levels of calcium, phosphorus, and total cholesterol. Furthermore, graft use as compared with fistula use was associated with an 1.4-fold (95% CI 1.0-1.9) increased risk of primary patency loss and with an 1.5-fold(95% CI 1.0-2.2) increased mortality risk. CONCLUSION: Cardiovascular disease, prior catheter use, albumin, hsCRP, and fetuin-A are risk factors for patency loss. Graft use as compared with fistula use was associated with an increased risk of patency loss and mortality. BioMed Central 2013-04-04 /pmc/articles/PMC3621613/ /pubmed/23557085 http://dx.doi.org/10.1186/1471-2369-14-79 Text en Copyright © 2013 Ocak et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Ocak, Gürbey
Rotmans, Joris I
Vossen, Carla Y
Rosendaal, Frits R
Krediet, Raymond T
Boeschoten, Elisabeth W
Dekker, Friedo W
Verduijn, Marion
Type of arteriovenous vascular access and association with patency and mortality
title Type of arteriovenous vascular access and association with patency and mortality
title_full Type of arteriovenous vascular access and association with patency and mortality
title_fullStr Type of arteriovenous vascular access and association with patency and mortality
title_full_unstemmed Type of arteriovenous vascular access and association with patency and mortality
title_short Type of arteriovenous vascular access and association with patency and mortality
title_sort type of arteriovenous vascular access and association with patency and mortality
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3621613/
https://www.ncbi.nlm.nih.gov/pubmed/23557085
http://dx.doi.org/10.1186/1471-2369-14-79
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