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Related Experiment Videos

The function of permanent vascular access.

J A Rodriguez1, L Armadans, E Ferrer

  • 1Hospital General Universitario Vall d'Hebron, Servicio de Nefrologia, Barcelona, Spain.

Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association
|February 29, 2000
PubMed
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Vascular access (VA) complications are common in renal replacement therapy (RRT). Radiocephalic and humerobasilic arteriovenous fistulae offer long function duration, but initial failure rates vary, influenced by factors like age and diabetes.

Area of Science:

  • Nephrology
  • Vascular Surgery
  • Public Health

Background:

  • Vascular access (VA) complications significantly impact morbidity in renal replacement therapy (RRT) patients.
  • These complications increase healthcare costs and provider frustration.
  • Identifying factors related to VA malfunction is crucial for preventing future failures.

Purpose of the Study:

  • To analyze the types, duration, and patency rates of permanent vascular accesses.
  • To identify patient characteristics and risk factors associated with VA failure.
  • To evaluate VA outcomes in specific patient subgroups, including those starting hemodialysis (HD) with a catheter.

Main Methods:

  • Retrospective analysis of 1033 permanent VA in 544 RRT patients over 13 years.

Related Experiment Videos

  • Data collection included VA type, duration, primary patency rate, patient characteristics, and failure incidence.
  • Separate analysis of VA outcomes for patients initiating HD with a catheter or experiencing initial VA failure.

    • Main Results:

    • Radiocephalic and humerobasilic arteriovenous fistulae demonstrated the longest functional durations (over 7 and 5 years, respectively).
    • Initial failure rates were highest for radiocephalic fistulae (25%).
    • Risk factors for VA failure included older age, female gender, diabetic nephropathy, starting dialysis with a catheter, and premature VA use.

    Conclusions:

    • Radiocephalic and humerobasilic AV fistulae are optimal for long-term vascular access in RRT.
    • High initial failure rates for radiocephalic fistulae necessitate careful patient selection and monitoring.
    • Patient-specific factors significantly influence VA longevity and failure risk during RRT.