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Upper-arm hemodialysis access in Sweden.

Ulf Hedin1, Gunilla Welander2

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Summary

Upper-arm access for hemodialysis is increasing in Sweden, particularly among women, with brachiocephalic arteriovenous fistula (AVF) being most common. A national registry aids in improving access care.

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Area of Science:

  • Nephrology
  • Vascular Surgery
  • Public Health

Background:

  • Hemodialysis access is crucial for patients with end-stage renal disease.
  • Upper-arm access offers an alternative to other vascular access types.
  • Understanding current trends in access utilization is vital for patient care.

Purpose of the Study:

  • To analyze contemporary usage patterns of upper-arm access for hemodialysis in Sweden.
  • To leverage data from a unique national hemodialysis access registry.
  • To identify trends in access type selection and patient demographics.

Main Methods:

  • Utilized data from the Swedish national Dialysis Access Database (DiAD).
  • Focused analysis on the use and function of upper-arm accesses.
  • Examined specific access types including brachiocephalic arteriovenous fistula (AVF) and arteriovenous grafts (AVGs).

Main Results:

  • Demonstrated a significant increase in the utilization of upper-arm access.
  • Identified brachiocephalic AVF as the predominant upper-arm access type.
  • Observed higher rates of upper-arm access in women compared to men.
  • Preliminary data suggested better function for brachiobasilic AVFs and upper-arm AVGs in women.

Conclusions:

  • Swedish registry data confirm a rising trend in upper-arm access use, especially among women.
  • The findings highlight the potential of national registries to enhance hemodialysis access care.
  • Further research is warranted to fully understand access function and patency over time.