title: Type of vascular access and location in online hemodiafiltration and its association with patient's perception of health-related quality of life.
abstract: OBJECTIVE
  The aim of this work is to evaluate the patient-reported health-related quality of life (HRQOL), according to the type and location of vascular access used for dialysis procedure.
  
  
  METHODS
  In this transversal study, 322 end-stage renal disease (ESRD) patients under online hemodiafiltration (OL-HDF, 59.63% males; 64.9±14.3 years) were enrolled. Arteriovenous fistula (AVF) was used by 252 patients (78.3%), whereas 70 patients (21.7%) had a central venous catheter (CVC). Besides AVF location, data on comorbidities, hematological data, iron status, dialysis adequacy, nutritional and inflammatory markers were collected. Moreover, the patients' reported HRQOL score, using the Kidney Disease Quality of Life-Short Form, was evaluated.
  
  
  RESULTS
  ESRD patients using CVC as vascular access presented a decrease in four SF-36 domain scores, namely physical functioning, emotional well-being, role-emotional and energy/fatigue when compared with those using AVF as vascular access. Additionally, these patients also showed significant differences in ESRD target areas, namely decline in cognitive function and quality of social interaction domains. When comparing the variables according to the localization of the AVF, significant differences were found in three SF-36 domain scores, namely physical functioning, pain and general health. Moreover, we also found significant differences in ESRD target areas, namely symptoms/problem list, effects of kidney disease and quality of social interaction domains.
  
  
  CONCLUSIONS
  Our results showed that ESRD patients under OL-HDF using AVF as vascular access had higher HRQOL scores in several domains when compared with those using CVC. Additionally, we also found that dialysis patients using AVF in the left forearm presented with higher HRQOL scores.
authors.affiliation: 1 Instituto de Ciências da Saúde, Universidade Católica Portuguesa, Porto - Portugal.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Moura
authors.forename: José
authors.initials: J
authors.lastname: Madureira
authors.forename: Pablo
authors.initials: P
authors.lastname: Alija
authors.forename: João Carlos
authors.initials: JC
authors.lastname: Fernandes
authors.forename: José Gerardo
authors.initials: JG
authors.lastname: Oliveira
authors.forename: Martin
authors.initials: M
authors.lastname: Lopez
authors.forename: Madalena
authors.initials: M
authors.lastname: Filgueiras
authors.forename: Leonilde
authors.initials: L
authors.lastname: Amado
authors.forename: Maria
authors.initials: M
authors.lastname: Sameiro-Faria
authors.forename: Vasco
authors.initials: V
authors.lastname: Miranda
authors.forename: Margarida
authors.initials: M
authors.lastname: Vieira
authors.forename: Alice
authors.initials: A
authors.lastname: Santos-Silva
authors.forename: Elísio
authors.initials: E
authors.lastname: Costa
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001166:Arteriovenous Shunt, Surgical / Q000009:adverse effects / Q000523:psychology*; D002405:Catheterization, Central Venous / Q000009:adverse effects / Q000523:psychology*; D015897:Comorbidity; D004644:Emotions; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006304:Health Status; D017583:Hemodiafiltration / Q000009:adverse effects / Q000523:psychology*; D006801:Humans; D007398:Interpersonal Relations; D007676:Kidney Failure, Chronic / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D010361:Patients / Q000523:psychology*; D010465:Perception; D011788:Quality of Life; D012307:Risk Factors; D011795:Surveys and Questionnaires; D016896:Treatment Outcome