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A Murine Model of Hemodialysis Access-Related Hand Dysfunction
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Arteriovenous access placement and renal function decline.

Ulrika Hahn Lundström1, Ulf Hedin2, Alessandro Gasparini3

  • 1Karolinska Institutet, Division of Renal Medicine, Clintec, Stockholm, Sweden.

Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association
|October 31, 2019
PubMed
Summary
This summary is machine-generated.

Arteriovenous access (AVA) placement did not significantly alter estimated glomerular filtration rate (eGFR) decline compared to peritoneal dialysis catheter (PDC) placement. Both access types showed reduced eGFR decline, with dialysis need being the primary factor for timing surgery.

Keywords:
arteriovenous accesschronic kidney disease progressioneGFR declinehaemodialysisperitoneal dialysis

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Area of Science:

  • Nephrology
  • Vascular Surgery
  • Renal Medicine

Background:

  • Conflicting evidence exists regarding whether arteriovenous access (AVA) placement protects renal function.
  • This study addresses the controversial role of AVA in preserving kidney function relative to peritoneal dialysis catheter (PDC) placement.

Purpose of the Study:

  • To investigate the association between AVA placement and estimated glomerular filtration rate (eGFR) decline.
  • To compare eGFR decline in patients receiving AVA versus PDC at similar time points.

Main Methods:

  • A cohort of 744 pre-dialysis patients in Stockholm (2006-2012) undergoing AVA or PDC surgery was studied.
  • Data on comorbidity, medication, and laboratory measures were collected pre- and post-surgery.
  • eGFR decline was analyzed using linear mixed models before and after access placement.

Main Results:

  • 435 patients received AVA and 309 received PDC.
  • AVA patients had higher baseline eGFR and slower pre-surgery decline compared to PDC patients.
  • No significant difference in post-surgery eGFR decline was observed between AVA and PDC groups.

Conclusions:

  • AVA placement showed no significant difference in eGFR decline compared to PDC placement.
  • Both AVA and PDC were associated with reduced eGFR decline post-placement.
  • The timing of access surgery is primarily determined by the need for dialysis.