Cargando…

Risk of Complications and Survival of Patients Dialyzed with Permanent Catheters

Background and Objectives: An increase in the incidence of end-stage renal disease (ESRD) is associated with the need for a wider use of vascular access. Although arteriovenous (A-V) fistula is a preferred form of vascular access, for various reasons, permanent catheters are implanted in many patien...

Descripción completa

Detalles Bibliográficos
Autores principales: Szarnecka-Sojda, Anna, Jacheć, Wojciech, Polewczyk, Maciej, Łętek, Agnieszka, Miszczuk, Jarosław, Polewczyk, Anna
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7023029/
https://www.ncbi.nlm.nih.gov/pubmed/31861701
http://dx.doi.org/10.3390/medicina56010002
_version_ 1783498154292805632
author Szarnecka-Sojda, Anna
Jacheć, Wojciech
Polewczyk, Maciej
Łętek, Agnieszka
Miszczuk, Jarosław
Polewczyk, Anna
author_facet Szarnecka-Sojda, Anna
Jacheć, Wojciech
Polewczyk, Maciej
Łętek, Agnieszka
Miszczuk, Jarosław
Polewczyk, Anna
author_sort Szarnecka-Sojda, Anna
collection PubMed
description Background and Objectives: An increase in the incidence of end-stage renal disease (ESRD) is associated with the need for a wider use of vascular access. Although arteriovenous (A-V) fistula is a preferred form of vascular access, for various reasons, permanent catheters are implanted in many patients. Materials and Methods: A retrospective analysis of clinical data was carried out in 398 patients (204 women) who in 2010–2016 were subjected to permanent dialysis catheters implantation as first vascular access or following A-V fistula dysfunction. The factors influencing the risk of complications related to vascular access and mortality were evaluated and the comparison of the group of patients with permanent catheter implantation after A-V fistula dysfunction with patients with first-time catheter implantation was carried out. Results: The population of 398 people with ESRD with mean age of 68.73 ± 13.26 years had a total of 495 permanent catheters implanted. In 129 (32.6%) patients, catheters were implanted after dysfunction of a previously formed dialysis fistula. An upward trend was recorded in the number of permanent catheters implanted in relation to A-V fistulas. Ninety-two infectious complications (23.1%) occurred in the study population in 65 patients (16.3%). Multivariate analysis showed that permanent catheters were more often used as the first vascular access option in elderly patients and cancer patients. Mortality in the mean 1.38 ± 1.17 years (min 0.0, max 6.70 years) follow-up period amounted to 50%. Older age and atherosclerosis were the main risk factors for mortality. Patients with dialysis fistula formed before the catheter implantation had a longer lifetime compared to the group in which the catheter was the first access. Conclusion: The use of permanent catheters for dialysis therapy is associated with a relatively high incidence of complications and low long-term survival. The main factors determining long-term survival were age and atherosclerosis. Better prognosis was demonstrated in patients after the use of A-V fistula as the first vascular access option.
format Online
Article
Text
id pubmed-7023029
institution National Center for Biotechnology Information
language English
publishDate 2019
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-70230292020-03-12 Risk of Complications and Survival of Patients Dialyzed with Permanent Catheters Szarnecka-Sojda, Anna Jacheć, Wojciech Polewczyk, Maciej Łętek, Agnieszka Miszczuk, Jarosław Polewczyk, Anna Medicina (Kaunas) Article Background and Objectives: An increase in the incidence of end-stage renal disease (ESRD) is associated with the need for a wider use of vascular access. Although arteriovenous (A-V) fistula is a preferred form of vascular access, for various reasons, permanent catheters are implanted in many patients. Materials and Methods: A retrospective analysis of clinical data was carried out in 398 patients (204 women) who in 2010–2016 were subjected to permanent dialysis catheters implantation as first vascular access or following A-V fistula dysfunction. The factors influencing the risk of complications related to vascular access and mortality were evaluated and the comparison of the group of patients with permanent catheter implantation after A-V fistula dysfunction with patients with first-time catheter implantation was carried out. Results: The population of 398 people with ESRD with mean age of 68.73 ± 13.26 years had a total of 495 permanent catheters implanted. In 129 (32.6%) patients, catheters were implanted after dysfunction of a previously formed dialysis fistula. An upward trend was recorded in the number of permanent catheters implanted in relation to A-V fistulas. Ninety-two infectious complications (23.1%) occurred in the study population in 65 patients (16.3%). Multivariate analysis showed that permanent catheters were more often used as the first vascular access option in elderly patients and cancer patients. Mortality in the mean 1.38 ± 1.17 years (min 0.0, max 6.70 years) follow-up period amounted to 50%. Older age and atherosclerosis were the main risk factors for mortality. Patients with dialysis fistula formed before the catheter implantation had a longer lifetime compared to the group in which the catheter was the first access. Conclusion: The use of permanent catheters for dialysis therapy is associated with a relatively high incidence of complications and low long-term survival. The main factors determining long-term survival were age and atherosclerosis. Better prognosis was demonstrated in patients after the use of A-V fistula as the first vascular access option. MDPI 2019-12-19 /pmc/articles/PMC7023029/ /pubmed/31861701 http://dx.doi.org/10.3390/medicina56010002 Text en © 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Szarnecka-Sojda, Anna
Jacheć, Wojciech
Polewczyk, Maciej
Łętek, Agnieszka
Miszczuk, Jarosław
Polewczyk, Anna
Risk of Complications and Survival of Patients Dialyzed with Permanent Catheters
title Risk of Complications and Survival of Patients Dialyzed with Permanent Catheters
title_full Risk of Complications and Survival of Patients Dialyzed with Permanent Catheters
title_fullStr Risk of Complications and Survival of Patients Dialyzed with Permanent Catheters
title_full_unstemmed Risk of Complications and Survival of Patients Dialyzed with Permanent Catheters
title_short Risk of Complications and Survival of Patients Dialyzed with Permanent Catheters
title_sort risk of complications and survival of patients dialyzed with permanent catheters
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7023029/
https://www.ncbi.nlm.nih.gov/pubmed/31861701
http://dx.doi.org/10.3390/medicina56010002
work_keys_str_mv AT szarneckasojdaanna riskofcomplicationsandsurvivalofpatientsdialyzedwithpermanentcatheters
AT jachecwojciech riskofcomplicationsandsurvivalofpatientsdialyzedwithpermanentcatheters
AT polewczykmaciej riskofcomplicationsandsurvivalofpatientsdialyzedwithpermanentcatheters
AT łetekagnieszka riskofcomplicationsandsurvivalofpatientsdialyzedwithpermanentcatheters
AT miszczukjarosław riskofcomplicationsandsurvivalofpatientsdialyzedwithpermanentcatheters
AT polewczykanna riskofcomplicationsandsurvivalofpatientsdialyzedwithpermanentcatheters