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A Murine Model of Hemodialysis Access-Related Hand Dysfunction
Published on: May 31, 2022
[Prototyping a new registry of vascular accesses for hemodialysis]
Maria Luisa Lefons1, Salvatore Accoto2, Francesco Caccetta3
1U.O.C. Nefrologia-Dialisi e Trapianto Renale PO V. Fazzi Lecce.
Insights
A new registry of vascular accesses (VA) improved patient management. Data on 726 patients showed native arteriovenous fistulas (AVF) were most common, with variations by age, gender, and diabetes status.
Area of Science:
- Nephrology
- Vascular Surgery
- Epidemiology
Background:
- Effective management of vascular access (VA) is crucial for patients requiring hemodialysis.
- Previous data on VA prevalence and characteristics in this health district were limited.
- A comprehensive registry is needed to improve VA management and understand patient demographics.
Purpose of the Study:
- To develop and implement a new registry for vascular accesses (VA) in a specific health district.
- To collect detailed data on VA types, locations, and patient characteristics.
- To improve the clinical and epidemiological understanding of VA management.
Main Methods:
- A registry was created to record VA data for prevalent patients as of December 31, 2017.
- Data collected included VA type, location, vessels involved, surgical history, and anastomosis type.
- For Central Venous Catheters (CVC), reason for use, site, and characteristics were recorded.
Main Results:
- The registry included 726 patients (average age 66±15 years, 63% male).
- Native arteriovenous fistulas (AVF) comprised 84% of VAs, predominantly in the distal forearm (65%).
- Central Venous Catheters (CVC) accounted for 14.5% of VAs, with higher prevalence in women and diabetics. Arteriovenous Grafts (AVG) were 1.7%.
Conclusions:
- The developed VA registry successfully captured essential clinical and epidemiological data.
- The registry provides a foundation for improved VA management and targeted interventions.
- Analysis revealed demographic and clinical factors influencing VA type selection and placement.
Abstract:
We have developed a new registry of the Vascular Accesses (VA) of all the patients afferent to our health district in order to improve their management. We recorded all the VAs of the prevalent patients on 12/31/2017. The VA type and location, the vessels involved, the number of surgical procedures received by the patient and the kind of anastomosis of the VA were all recorded. As for Central Venous Catheters (CVC), we recorded the reason for the choice as well as the site and the characteristics of CVC. Results: The VA of 726 prevalent patients were registered. Their age was 66+15 years on average, and 63% were male. The native arteriovenous fistulas (AVF) were 609 (84%), of which 65% were located on the distal forearm (DF), 10% on the middle forearm (MF), 5% on proximal forearm (PF), 4% on the arm (AM). The arteriovenous Grafts (AVG) were 12 (1.7%). The CVCs were 105 (14.5%). More women than men received a CVC (p<0.005) or an AVF on the AM (p<0.05). Patients over 75 had less FAVs in the AM (P<0.05) and less Grafts (P<0.05). Diabetics patients had more CVCs (p<0.05) but were generally older (p<0.001). Patients in HD for renal transplantation loss had more AVFs at the arm (p<0.001) and Grafts (p<0.001), and less AVFs on the DF (p>0.001). The comparison of data between 2013 and 2017 shows a steady situation in the prevalence of VA. Conclusions: The new VA registry has allowed us to detect and record important information, both from a clinical and an epidemiological point of view.
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