Haemodialysis catheters increase mortality as compared to arteriovenous accesses especially in elderly patients.
Nephrol Dial Transplant
; 26(8): 2611-7, 2011 Aug.
Article
em En
| MEDLINE
| ID: mdl-21282302
ABSTRACT
BACKGROUND:
Catheter use has been associated with an increased mortality risk in haemodialysis patients. However, differences in the all-cause and cause-specific mortality risk between catheter use and arteriovenous access use in young and elderly haemodialysis patients have not yet been investigated.METHODS:
In this prospective cohort study of 1109 incident haemodialysis patients from 38 centres in the Netherlands, hazard ratios (HRs) with 95% confidence intervals (95% CIs) were calculated for 2-year all-cause, infection-related and cardiovascular mortality in patients with a catheter as compared to patients with an arteriovenous access stratified for age (< 65 years and ≥ 65 years).RESULTS:
Of the 1109 patients, 919 had an arteriovenous access and 190 had a catheter. The mortality rate was 76 per 1000 person-years in young patients with an arteriovenous access, 129 per 1000 person-years in young patients with a catheter, 222 per 1000 person-years in elderly patients with an arteriovenous access and 427 per 1000 person-years in elderly patients with a catheter. The adjusted HR was 3.15 (95% CI 2.09-4.75) for elderly patients with a catheter as compared to young patients with an arteriovenous access. The adjusted HRs in elderly patients with a catheter as compared to elderly patients with an arteriovenous access were 1.54 (95% CI 1.13-2.12) for all-cause mortality, 1.60 (95% CI 0.62-4.19) for infection-related mortality and 1.67 (95% CI 1.04-2.68) for cardiovascular mortality.CONCLUSIONS:
Especially, elderly haemodialysis patients with a catheter have an increased all-cause, infection-related and cardiovascular mortality risk as compared to patients with an arteriovenous access.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Derivação Arteriovenosa Cirúrgica
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Cateteres de Demora
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Diálise Renal
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Falência Renal Crônica
Tipo de estudo:
Clinical_trials
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Etiology_studies
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Incidence_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Aged
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Female
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Humans
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Male
País como assunto:
Europa
Idioma:
En
Ano de publicação:
2011
Tipo de documento:
Article