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Outcomes of arteriovenous access among cancer patients requiring chronic haemodialysis

BACKGROUND: There are limited data focusing specifically on the types of arteriovenous (AV) access used and outcomes of AV access among cancer patients as a consequence of cancer. We aimed to describe outcomes of AV access among cancer patients requiring chronic haemodialysis, and also to compare ou...

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Autores principales: Jeong, Seonjeong, Kwon, Hyunwook, Chang, Jai Won, Han, Youngjin, Kwon, Tae-Won, Cho, Yong-Pil
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7379794/
https://www.ncbi.nlm.nih.gov/pubmed/32703168
http://dx.doi.org/10.1186/s12882-020-01969-5
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author Jeong, Seonjeong
Kwon, Hyunwook
Chang, Jai Won
Han, Youngjin
Kwon, Tae-Won
Cho, Yong-Pil
author_facet Jeong, Seonjeong
Kwon, Hyunwook
Chang, Jai Won
Han, Youngjin
Kwon, Tae-Won
Cho, Yong-Pil
author_sort Jeong, Seonjeong
collection PubMed
description BACKGROUND: There are limited data focusing specifically on the types of arteriovenous (AV) access used and outcomes of AV access among cancer patients as a consequence of cancer. We aimed to describe outcomes of AV access among cancer patients requiring chronic haemodialysis, and also to compare outcomes between patients with and without cancer. METHODS: In this single-centre, retrospective, observational cohort study, 84 patients diagnosed with cancer before AV access placement were included; we analysed outcomes of AV access among these patients and compared these outcomes with our previous results. The study endpoints were AV access patency and early failure, defined as AV access abandonment within 12 months after AV access placement. RESULTS: Various cancer types, stages, and treatments were identified in our analysis. Autologous arteriovenous fistulas (AVFs) were used for 92.9% of this study population. Using our previous results for comparison, we found no significant difference in death-censored primary (P = 0.546) and secondary (P = 0.266) patency of AV access between patients with and without cancer; however, the rate of early AVF failure was statistically significantly higher among cancer patients (25.6% vs 13.9%; P = 0.008), and the most common cause of AVF failure was patient death. The rate of early failure was significantly higher among patients with advanced-stage cancer (59.1%) than among those with early-stage cancer (12.9%) (P <  0.001). CONCLUSIONS: Although AV access patency rates were similar among patients with and without cancer in the death-censored analysis, cancer patients were more prone to early AVF failure, mainly due to cancer-associated deaths, and this consideration needs to be carefully balanced against individual patients’ life expectancies, according to cancer type and stage.
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spelling pubmed-73797942020-08-04 Outcomes of arteriovenous access among cancer patients requiring chronic haemodialysis Jeong, Seonjeong Kwon, Hyunwook Chang, Jai Won Han, Youngjin Kwon, Tae-Won Cho, Yong-Pil BMC Nephrol Research Article BACKGROUND: There are limited data focusing specifically on the types of arteriovenous (AV) access used and outcomes of AV access among cancer patients as a consequence of cancer. We aimed to describe outcomes of AV access among cancer patients requiring chronic haemodialysis, and also to compare outcomes between patients with and without cancer. METHODS: In this single-centre, retrospective, observational cohort study, 84 patients diagnosed with cancer before AV access placement were included; we analysed outcomes of AV access among these patients and compared these outcomes with our previous results. The study endpoints were AV access patency and early failure, defined as AV access abandonment within 12 months after AV access placement. RESULTS: Various cancer types, stages, and treatments were identified in our analysis. Autologous arteriovenous fistulas (AVFs) were used for 92.9% of this study population. Using our previous results for comparison, we found no significant difference in death-censored primary (P = 0.546) and secondary (P = 0.266) patency of AV access between patients with and without cancer; however, the rate of early AVF failure was statistically significantly higher among cancer patients (25.6% vs 13.9%; P = 0.008), and the most common cause of AVF failure was patient death. The rate of early failure was significantly higher among patients with advanced-stage cancer (59.1%) than among those with early-stage cancer (12.9%) (P <  0.001). CONCLUSIONS: Although AV access patency rates were similar among patients with and without cancer in the death-censored analysis, cancer patients were more prone to early AVF failure, mainly due to cancer-associated deaths, and this consideration needs to be carefully balanced against individual patients’ life expectancies, according to cancer type and stage. BioMed Central 2020-07-23 /pmc/articles/PMC7379794/ /pubmed/32703168 http://dx.doi.org/10.1186/s12882-020-01969-5 Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research Article
Jeong, Seonjeong
Kwon, Hyunwook
Chang, Jai Won
Han, Youngjin
Kwon, Tae-Won
Cho, Yong-Pil
Outcomes of arteriovenous access among cancer patients requiring chronic haemodialysis
title Outcomes of arteriovenous access among cancer patients requiring chronic haemodialysis
title_full Outcomes of arteriovenous access among cancer patients requiring chronic haemodialysis
title_fullStr Outcomes of arteriovenous access among cancer patients requiring chronic haemodialysis
title_full_unstemmed Outcomes of arteriovenous access among cancer patients requiring chronic haemodialysis
title_short Outcomes of arteriovenous access among cancer patients requiring chronic haemodialysis
title_sort outcomes of arteriovenous access among cancer patients requiring chronic haemodialysis
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7379794/
https://www.ncbi.nlm.nih.gov/pubmed/32703168
http://dx.doi.org/10.1186/s12882-020-01969-5
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