Initial hemodialysis with a temporary catheter is associated with complications of a later permanent vascular access.
The aim was to identify the risk factors of long-term vascular access complications. The study cohort consisted of 239 incident hemodialysis (HD) patients from 1998 to 2010 in a single center. Among these patients, 59.8% had initially been dialyzing with a temporary catheter. Within 3 months after starting dialysis, all catheters had been converted into permanent accesses. 45 patients incurred long-term access complications after the first 2 years of dialysis, and 34 (75.6%) had used a temporary catheter starting HD. Complication occurrence was associated with age, initiation dialysis with a catheter and heart failure by logistic regression (odds ratios were 1.04, 2.77 and 2.23, respectively; p < 0.05). The 2-year primary patency rates of arteriovenous fistulae were significantly higher than those of arteriovenous grafts (79.5 vs. 50%, p = 0.002). We concluded that age, using a catheter and heart failure in HD initiation had a strong impact on long-term access complications.
Renal Division, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China.
Mingli
M
Zhu
Weiming
W
Zhang
Wenyan
W
Zhou
Yijun
Y
Zhou
Yan
Y
Fang
Yongmei
Y
Wang
Haifen
H
Zhang
Yucheng
Y
Yan
Zhaohui
Z
Ni
Jiaqi
J
Qian
D000328:Adult; D000368:Aged; D001164:Arteriovenous Fistula / Q000209:etiology; D057785:Catheters / Q000009:adverse effects; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis / Q000009:adverse effects; D012189:Retrospective Studies; D012307:Risk Factors