摘要
Vascular access failure (VAF) is associated with increased morbidity and mortality in hemodialysis patients. However, it is seldom studied in southern Taiwan, an area with high prevalence of end-stage renal disease. The aim of this study is to evaluate the risk factors for vascular access survival in a hospital. All 225 routine hemodialysis patients in one regional hospital were included in the study. The study subjects were observed from arteriovenous access creation until the first episode of VAF. The relative VAF risk was analyzed by Cox-regression methods with adjustments for demographic and comorbid conditions. Results: After the multivariate analysis, vascular access type of arteriovenous graft (AVG) was positively associated with VAF (hazard ratio [HR]= 2.384). We further analyzed the subgroup patients with arteriovenous fistula (AVF) and found that diabetes mellitus (DM) was significantly correlated with AVF failure in the multivariate analysis (HR= 2.430). Our findings show that vascular access type of AVG was significantly associated with a poor vascular access outcome, and DM was a risk factor for AVF failure. These results support clinical guidelines that recommend superior choice of a native fistula and address the importance of AVF care in the diabetic hemodialysis patients.
並列摘要
Vascular access failure (VAF) is associated with increased morbidity and mortality in hemodialysis patients. However, it is seldom studied in southern Taiwan, an area with high prevalence of end-stage renal disease. The aim of this study is to evaluate the risk factors for vascular access survival in a hospital. All 225 routine hemodialysis patients in one regional hospital were included in the study. The study subjects were observed from arteriovenous access creation until the first episode of VAF. The relative VAF risk was analyzed by Cox-regression methods with adjustments for demographic and comorbid conditions. Results: After the multivariate analysis, vascular access type of arteriovenous graft (AVG) was positively associated with VAF (hazard ratio [HR]= 2.384). We further analyzed the subgroup patients with arteriovenous fistula (AVF) and found that diabetes mellitus (DM) was significantly correlated with AVF failure in the multivariate analysis (HR= 2.430). Our findings show that vascular access type of AVG was significantly associated with a poor vascular access outcome, and DM was a risk factor for AVF failure. These results support clinical guidelines that recommend superior choice of a native fistula and address the importance of AVF care in the diabetic hemodialysis patients.
延伸閱讀
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