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Related Experiment Videos

Failure of dialysis access: revise or replace?

T E Brothers1, M Morgan, J G Robison

  • 1Ralph Henry Johnson Department of Veterans Affairs Medical Center, Charleston, South Carolina 29425, USA.

The Journal of Surgical Research
|February 1, 1996
PubMed
Summary

Dialysis access failure is common, with revisions failing faster than new accesses. Patients with prior access issues and octogenarians face higher risks of early failure.

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Contemporary analysis of outcomes following lower extremity bypass in patients with end-stage renal disease.

Annals of vascular surgery·2001

Area of Science:

  • Vascular Surgery
  • Nephrology
  • Dialysis Access Management

Background:

  • Adequate long-term dialysis access is crucial but challenging.
  • Early failure of dialysis access impacts patient outcomes and healthcare costs.

Purpose of the Study:

  • To identify operative factors linked to early dialysis access failure.
  • To analyze time-to-failure for different types of dialysis access procedures.

Main Methods:

  • Retrospective review of 2337 operations in 1124 patients over 8 years.
  • Analysis focused on 1306 procedures that failed and required revision or repair.
  • Statistical comparison of time-to-failure based on access type, site, and patient demographics.

Main Results:

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  • Access failure occurred in 459 (41%) patients, averaging 2.8 failure episodes per patient.
  • Revision of pre-existing arteriovenous fistula or graft failed significantly faster (140 days) than new accesses (272-299 days).
  • Procedures in octogenarians and patients with prior access problems showed a trend toward earlier failure.

Conclusions:

  • Dialysis access revision is associated with significantly shorter time-to-failure compared to new access creation.
  • Recurrence of access failure is common in patients with a history of previous access problems.
  • Patient age (octogenarians) and history of access issues are factors influencing early failure.