Permanent vascular access in patients with end-stage renal disease, Brazil

Silva, Gisele Macedo da; Gómes, Isabel Cristina; Andrade, Eli Iôla Gurgel; Lima, Eleonora Moreira; Acúrcio, Francisco de Assis; Cherchiglia, Mariângela Leal

doi:10.1590/s0034-89102011005000005

Cited by 7 publications

(9 citation statements)

References 21 publications

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“…4 Despite being a safe option in emergency situations, unlike the permanent vascular access, temporary venous catheters have a high incidence of complications, such as infection, thrombosis, lower dwell time compared to other vascular accesses, and a lower blood flow rate, which reduces the effectiveness of hemodiaysis. [5][6] The temporary catheter is primarily responsible for about 48-73% of bacteremia occurring in patients on hemodialysis treament. 7 The high incidence of intravenous line-related infections has stimulated the development of studies to determine the specific elements that cause this phenomenon because general factors such as clinical conditions, extremes of age and comorbidities such as diabetes, hypertension, obesity and malnutrition are already known.…”

Section: Introductionmentioning

confidence: 99%

Risk Factors Associated With Temporary Catheter-Related Infection in Patients on Dialysis Treatment

Borges¹,

Bedendo

2015

Texto contexto - enferm.

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ABSTRACT:This study aims to identify risk factors associated with temporary hemodialysis catheter-related infection, in patients on dialysis treatment in a teaching hospital. This is a prospective study performed from November of 2012 to May of 2013, with 129 patients. Sociodemographic, clinical and biochemical data were collected from patient charts. In patients with a catheter,, 48.8% had catheter-related infection, 65% were male, 65% were 60 years of age or older, 85.3% had the catheter because they were diagnosed with acute renal failure, and 88% were hospitalized in an intensive care unit. There was a significant correlation between the independent variables and the outcome of infection. The risk factors associated with temporary hemodialysis catheter-related infection were: length of time of catheter use, the change of device, death, and complications during a hemodialysis session. DESCRIPTORS:Risk factors. Catheter-related infections. Renal insufficiency. Renal dialysis. FATORES DE RISCO ASSOCIADOS À INFECÇÃO DE CATETER PROVISÓRIO EM PACIENTES SOB TRATAMENTO DIALÍTICORESUMO: Este estudo objetivou identificar os fatores de risco associados à infecção de cateter provisório para hemodiálise em pacientes em tratamento dialítico em um hospital escola. Trata-se de um estudo prospectivo, realizado no período de novembro de 2012 a maio de 2013, com 129 pacientes. Os dados sóciodemograficos, clínicos e bioquímicos dos participantes foram coletados dos prontuários. Entre os pacientes que foram submetidos à implantação do cateter, 48,8% apresentaram infecção relacionada ao cateter, 65% eram do sexo masculino, 65% possuíam idade igual ou superior a 60 anos, 85,3% utilizaram o cateter por terem sido diagnosticados com insuficiência renal aguda e 88% foram internados em unidade de terapia intensiva. Houve correlação significativa entre as variáveis independentes e o desfecho infecção. Os fatores de risco que se associaram à infecção relacionada à implantação do dispositivo foram: tempo de permanência do cateter, troca do dispositivo, óbito e intercorrências durante a sessão de hemodiálise. DESCRITORES: FACTORES DE RIESGO ASOCIADOS A LA INFECCIÓN DE CATÉTER PROVISORIO EN PACIENTES EN TRATAMIENTO DIALÍTICO RESUMEN:Este estudio tuvo como objetivo identificar los factores de riesgo asociados a la infección de catéter provisorio para hemodiálisis en pacientes en tratamiento dialítico en un hospital escuela. Se trata de un estudio prospectivo, realizado en el período entre noviembre de 2012 y mayo de 2013, con 129 pacientes. Fueron colectados: registros sociodemográficos, clínicos y bioquímicos de los participantes se obtuvieron de los registros médicos. Entre los pacientes que fueron sometidos a la implantación del catéter, el 48,8% presentaron infección relacionada con catéter, el 65% eran del sexo masculino, el 65% tenían edad igual a 60 años o más, el 85,3% utilizaron el catéter porque hubieran sido diagnosticados con insuficiencia renal aguda y el 88% fueron hospitalizados en la unidad de terapia intensiva. Hubo correl...

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Section: Introductionmentioning

confidence: 99%

Risk Factors Associated With Temporary Catheter-Related Infection in Patients on Dialysis Treatment

Borges¹,

Bedendo

2015

Texto contexto - enferm.

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“…A Brazilian cross-sectional study comprising 2,276 patients reported a prevalence of 69% for NTCs at HD initiation. The risk factors for NTC use include pre-dialysis care for less than 1 year and lack of private insurance ( 11 ). A retrospective analysis of 5,081 Brazilian patients, 58.1% of whom were covered by the public health insurance system, found that, for 69.6% of patients, dialysis was initiated with a catheter (56% NTC and 13.6% TC) ( 12 ).…”

Section: Discussionmentioning

confidence: 99%

Health insurance provider and endovascular treatment availability are associated with different hemodialysis vascular access profiles: A Brazilian national survey

Franco¹,

Chula²,

Campos

2022

Front. Nephrol.

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In Brazil, most hemodialysis (HD) patients are treated by the country’s public health system. However, accessibility to healthcare is different for public and private patients. This study aimed to identify the profile of vascular access in a Brazilian HD sample. Additionally, it aimed to examine the influence of public and private health insurance, accessibility to endovascular treatments, and timely arteriovenous access creation on the prevalence of tunneled catheters (TCs), non-tunneled catheters (NTCs), and arteriovenous (AV) access. We conducted a cross-sectional electronic survey across 834 centers. Centers were inquired about the number of patients with public and private health insurance, the profiles of vascular access, time for AV access creation, accessibility to TC insertion and endovascular treatments, and the availability of peritoneal dialysis and kidney transplantation. Logistic regression and multilevel logistic regression were performed to evaluate possible interactions between the independent variables. A total of 7,973 patients across 47 HD centers were included in the survey. Public health patients accounted for 77% of the study sample. The overall vascular access profiles of the public and private insurance groups were significantly different (p < 0.001). For patients with public health insurance, the prevalence of any catheter was 25%, while that for private patients was 31.8% (p < 0.001). The prevalence of TCs was more common in private patients (15.3% vs. 23.1%, p < 0.001). AV accesses were more common in public health patients (75% vs. 68.2%, p < 0.001), as were fistulas (72.4% vs. 63.1%, p < 0.001). AV grafts were more prevalent among patients with private insurance (2.6 vs. 5.1%, p < 0.001). The availability of endovascular treatments increased the chance of having a TC by 2.3-fold (OR = 2.33, 95% CI = 1.30–4.18); however, it did not reduce the chance of having any catheter. A high chance of having a catheter was found when the time to AV access creation exceeded 60 days. The differences between public and private patients may be explained by underpayments and the decreased accessibility to care infrastructure in the public system, especially for endovascular treatments. In this sample, public health patients had a decreased risk of having a TC over an NTC. Differences in care accessibility and insurance type might influence the type of vascular access.

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“…Sesso et al (2008) 10 found that 34% of patients who started hemodialysis used fistulas. The other 66% were referred to the nephrologist to immediately start hemodialysis through a catheter 51 . The findings in Ceará were lower than the national ones for 2008 and there are not such comprehensive data for comparison.…”

Section: Discussionmentioning

confidence: 99%

Vascular accesses for hemodialysis in Ceará-Brazil

Lima

Lima²,

Abreu³

et al. 2022

jhgd

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Backgroung: the ideal access for hemodialysis is represented by arteriovenous fistulas both as initial access and in use and are determinants of health care parameters for chronic renal patients. Objective: to evaluate vascular access for hemodialysis. Methods: this is a cross-sectional study, with a sample of 2513 individuals on hemodialysis in Ceará. Data were collected on age, sex, time of treatment, underlying disease, initial access and access in use. The data were divided into two groups, the interior of the state and the Metropolitan Region of Fortaleza, in the State of Ceará, and compared using the Student’s Test (p<0.05). Results: the most common age group was between 19 and 64 years (73%). Men prevailed in both regions, 713 (63%) in the countryside and 792 (57%) in the metropolitan area. The most common cause of Chronic Kidney Disease was Hypertension 306 (27%), followed by Disease of undetermined cause 295 (26%) in the countryside; in the metropolitan region, Diabetes Mellitus 356 (26%) was the main cause, followed by Hypertension and Disease of undetermined cause, each with 344 (25%), p=0.001. In the countryside, 9% started treatment for fistula while in the metropolitan area 12%, p=0.011. 79% of patients in the countryside used fistulas and 81% in the metropolitan area, p=0.156. Conclusion: arteriovenous fistulas are more frequent as initial accesses in the metropolitan region than in the interior, but there is an equivalence of fistulas in use in both regions. Catheter is the main initial access route. The evaluation of vascular accesses in Ceará showed that hemodialysis services are able to maintain good parameters of care for patients with chronic kidney disease.

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Permanent vascular access in patients with end-stage renal disease, Brazil

Cited by 7 publications

References 21 publications

Risk Factors Associated With Temporary Catheter-Related Infection in Patients on Dialysis Treatment

Risk Factors Associated With Temporary Catheter-Related Infection in Patients on Dialysis Treatment

Health insurance provider and endovascular treatment availability are associated with different hemodialysis vascular access profiles: A Brazilian national survey

Vascular accesses for hemodialysis in Ceará-Brazil

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