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Type of arteriovenous vascular access and association with patency and mortality

Gürbey Ocak1, Joris I Rotmans, Carla Y Vossen

  • 1Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands.

BMC Nephrology
|April 6, 2013
PubMed

Insights

Arteriovenous graft use increases risks for hemodialysis patients, leading to higher rates of access failure and mortality compared to fistulas. Key risk factors for patency loss include cardiovascular disease and low albumin levels.

Area of Science:

  • Nephrology
  • Vascular Surgery
  • Epidemiology

Background:

  • Limited knowledge exists on risk factors for primary patency loss in arteriovenous grafts/fistulas.
  • Few studies explore the link between arteriovenous access type and outcomes like patency loss and mortality.

Purpose of the Study:

  • Identify risk factors for primary patency loss in hemodialysis patients.
  • Compare outcomes (patency loss, mortality) between arteriovenous grafts and fistulas.

Main Methods:

  • Prospective follow-up of 919 incident hemodialysis patients.
  • Cox regression analysis to calculate hazard ratios for risk factors.
  • Analysis of two-year primary patency loss and mortality based on access type.

Main Results:

  • Cardiovascular disease, prior catheter use, low albumin, high hsCRP, and low fetuin-A were linked to patency loss in both graft and fistula groups.
  • Age, female sex, and diabetes mellitus were associated with fistula patency loss.
  • Graft use showed a 1.4-fold increased risk of patency loss and 1.5-fold increased mortality risk compared to fistulas.

Conclusions:

  • Cardiovascular disease, prior catheter use, albumin, hsCRP, and fetuin-A are significant risk factors for arteriovenous access patency loss.
  • Arteriovenous graft use is associated with higher risks of both patency loss and mortality compared to arteriovenous fistula use.
Abstract

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