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...
Autores principales: | , , , , , |
---|---|
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 |