期刊
JOURNAL OF NEPHROLOGY
卷 34, 期 1, 页码 89-95出版社
SPRINGER HEIDELBERG
DOI: 10.1007/s40620-020-00834-w
关键词
Arteriovenous fistula; Central venous catheters; Peritoneal dialysis; Renal replacement therapy; Haemodialysis
In this cohort of peritoneal dialysis patients, the utilization of backup arteriovenous fistulas was higher than previously reported, and the presence of backup arteriovenous fistulas was associated with a lower rate of future catheter use.
Background Transitions from peritoneal dialysis (PD) to haemodialysis (HD) are often unpredictable and central venous catheters (CVCs) are frequently required. Early studies found few back-up arteriovenous fistulas (bAVFs) were ever used. The PD population's characteristics have changed over time which may have altered the likelihood of bAVFs being used. This study aimed to report use of, and outcomes associated with, bAVFs in a contemporary cohort of peritoneal dialysis patients. Method A single-centre, retrospective study of PD patients commencing dialysis between 2006-2016, stratified according to presence/absence of bAVF. Results One hundred seventy-six patients were included-82 with bAVF, 94 without bAVF-of whom 156 transitioned off PD. Transitions were to HD (49%), transplantation (23%), death (15%) and renal-recovery (1%). 51% of bAVFs were successfully used and 82% of bAVFs were patent when required. Median time from creation to bAVF use was 2.5 years. More patients with a bAVF transitioned to HD (62 vs 38%, p < 0.005). However, CVC requirement at the time of transition to HD was much less common in the bAVF group (18 vs 83%, p < 0.0001), such that the overall risk of requiring a CVC was significantly lower in the bAVF group (11 vs 31%, p < 0.005). Rates of returning to PD amongst patients who transitioned to HD with a CVC or an AVF were similar (19 vs 26%, p = 0.16). Conclusions In this cohort of PD patients, utilisation of few back-up arteriovenous fistulas was higher than previously reported, and presence of a few back-up arteriovenous fistula was associated with a lower rate of future CVC use.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据