title: Vascular access type, health-related quality of life, and depression in hemodialysis patients: a preliminary report.
abstract: OBJECTIVE
  Arteriovenous fistulas (AVF) are the vascular access of choice for hemodialysis (HD) compared with arteriovenous grafts (AVG) and central venous catheters (CVC). In spite of increasing recognition of importance of a patient's perception of health-related quality of life (HRQOL) and depression, few studies have assessed the association of vascular access type with HRQOL and depression. The purpose of our study was to examine HRQOL and depression among patients with different vascular access.
  
  
  METHODS
  Severity of symptoms of depression and HRQOL were assessed by Beck Depression Inventory (BDI) and Short Form-36 (SF-36), respectively. Vascular access was reported as one of three options; AVF, AVG, and CVC.
  
  
  RESULTS
  In total, 136 patients were included; 104 had AVF, 15 had AVG, and 17 had CVC. BDI and HRQOL parameters differed among patients with different vascular access types. In post hoc analysis, BDI and HRQOL subscales were not different between patients with AVF and AVG. Patients with CVC had lower physical functioning (P:.001), role-physical limitation (P:.015), general health perception (P:.017), vitality (P:.010), social functioning (P:.004), role-emotional (P:.008), mental health (P:.001), physical component summary score (P:.017), and mental component summary score (P:.006) when compared to patients with AVF. Patients with CVC had lower physical functioning (P:.044), role-emotional (P:.044) and mental health scores (P:.04) when compared to patients with AVG.
  
  
  CONCLUSIONS
  Having a CVC may negatively influence HRQOL in HD patients. Vascular access type does not seem to be related to depressed mood in HD.
authors.affiliation: Department of Nephrology, Zonguldak Atatürk Government Hospital, Zonguldak, Turkey. afsarbrs@yahoo.com
authors.forename: Baris
authors.initials: B
authors.lastname: Afsar
authors.forename: Rengin
authors.initials: R
authors.lastname: Elsurer
authors.forename: Adrian
authors.initials: A
authors.lastname: Covic
authors.forename: Mehmet
authors.initials: M
authors.lastname: Kanbay
mesh_terms: D000328:Adult; D000368:Aged; D001166:Arteriovenous Shunt, Surgical / Q000009:adverse effects / Q000523:psychology*; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000523:psychology*; D002405:Catheterization, Central Venous / Q000009:adverse effects / Q000523:psychology*; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D003863:Depression / Q000175:diagnosis / Q000209:etiology*; D004644:Emotions; D005260:Female; D006801:Humans; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D010465:Perception; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D006435:Renal Dialysis / Q000009:adverse effects / Q000523:psychology*; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome; D014421:Turkey