Outcomes of initial hemodialysis access surgery in an Asian population.
J Vasc Access
; 13(4): 409-14, 2012.
Article
em En
| MEDLINE
| ID: mdl-22427228
ABSTRACT
PURPOSE:
Access-related morbidity contributes substantially to the costs of hemodialysis. The aim of this study was to examine the outcomes of initial hemodialysis access surgery at a single center in Singapore and to analyze factors which might influence survival of the surgically-created access.METHODS:
Patients undergoing their first hemodialysis access operations between January 2003 and December 2007 were retrospectively identified. Primary and assisted primary patency rates were determined by the Kaplan-Meier method. Data on age, sex, diabetic status, and prior tunneled central venous catheter (CVC) use were analyzed against the outcome of arteriovenous fistulas (AVF).RESULTS:
During the study period, 410 primary upper limb access operations were performed 297 forearm AVF (72.4%), 91 upper arm AVF (22.2%), and 22 arteriovenous grafts (AVG; 5.4%). Men comprised 55.4%, 271 (66.1%) had diabetes, and 316 patients (77.1%) came to surgery with pre-existing CVC. Sixty-two percent of forearm AVF and 67% of arm AVF were used successfully. Age, sex, diabetes, and prior use of a CVC did not significantly affect the ability to use an AVF. Only in the female diabetic subgroup was an earlier loss of primary assisted patency of AVF recorded.CONCLUSIONS:
In our Asian population, we have demonstrated AVF patency rates equivalent to those of international centers. We now face the challenge of achieving a higher rate of pre-emptive AVF placement with a subsequent reduction in CVC use.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Derivação Arteriovenosa Cirúrgica
/
Diálise Renal
/
Extremidade Superior
/
Povo Asiático
/
Falência Renal Crônica
Tipo de estudo:
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Aged
/
Female
/
Humans
/
Male
/
Middle aged
País/Região como assunto:
Asia
Idioma:
En
Ano de publicação:
2012
Tipo de documento:
Article