title: Long-term survival of vascular accesses in a large chronic hemodialysis population.
abstract: Complications associated with vascular accesses account for approximately 30% of hospital admissions for chronic hemodialysis patients. Long-term patency of access was evaluated in 76 patients, without diabetes mellitus, who had been on dialysis for at least 3 years and 41 patients, with diabetes mellitus, who had been on dialysis for over 2 years. Fistulas functioned longer than grafts (58 vs. 22 months, p < 0.01, in nondiabetics and 70 vs 22 months, p < 0.01, in patients with diabetes). Declotting or revision of restored graft function for short periods of time (< 6-10 months) and subsequent declotting was ineffective. Infections were uncommon in grafts (1 per 13.5 years of dialysis) and in fistulas (1 in 200 years of dialysis).
authors.affiliation: Artificial Kidney Center of Rhode Island, Department of Medicine, Rhode Island Hospital, Brown University School of Medicine, Providence, USA.
authors.forename: J A
authors.initials: JA
authors.lastname: Chazan
authors.forename: M R
authors.initials: MR
authors.lastname: London
authors.forename: L M
authors.initials: LM
authors.lastname: Pono
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001166:Arteriovenous Shunt, Surgical / Q000009:adverse effects; D001807:Blood Vessel Prosthesis; D002408:Catheters, Indwelling / Q000009:adverse effects / Q000382:microbiology; D002648:Child; D002675:Child, Preschool; D003920:Diabetes Mellitus / Q000628:therapy; D005069:Evaluation Studies as Topic; D005260:Female; D006085:Graft Survival; D006801:Humans; D007239:Infections / Q000209:etiology; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis / Q000009:adverse effects* / Q000379:methods*; D013997:Time Factors; D014654:Vascular Patency