Arteriovenous Fistulae vs. Arteriovenous Grafts: A Retrospective Review of 1,700 Consecutive Vascular access Cases

Schild, A. Frederick; Perez, Enrique; Gillaspie, Erin A.; Seaver, Chris; Livingstone, Joshua; Thibonnier, A

doi:10.1177/112972980800900402

Cited by 142 publications

(101 citation statements)

References 29 publications

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“…Because of the high prevalence of catheter and graft use in the United States, European and United States studies are difficult to compare. The negative effect of catheters and grafts on albumin levels as well as the incidence of infection, and thus concomitantly higher CRP and IL-6 levels, is well known (12,14,19,20). Interestingly, both the prevalence of catheter use and the decrease in albumin and BMI in the US HEMO study were comparable with CONTRAST (6).…”

Section: Discussionsupporting

confidence: 67%

Clinical Predictors of Decline in Nutritional Parameters over Time in ESRD

Hoedt

Bots

Grooteman

et al. 2014

Clinical Journal of the American Society of Nephrology

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SummaryBackground and objectives Inflammation and malnutrition are important features in patients with ESRD; however, data on changes in these parameters over time are scarce. This study aimed to gain insight into changes over time in serum albumin, body mass index, high-sensitivity C-reactive protein, and IL-6 in patients with ESRD and aimed to identify clinical risk factors for deterioration of these parameters.Design, setting, participants, & measurements Data were analyzed from the Convective Transport Study, a randomized controlled trial conducted from June 2004 to January 2011, in which 714 patients with chronic ESRD were randomized to either online hemodiafiltration or low-flux hemodialysis. Albumin and body mass index were measured up to 6 years and predialysis C-reactive protein and IL-6 were measured up to 3 years in a subset of 405 participants. Rates of change in these parameters over time were estimated across strata of predefined risk factors with linear mixed-effects models.Results Albumin and body mass index decreased and C-reactive protein and IL-6 increased over time. For every incremental year of age at baseline, the yearly excess decline in albumin was 0.003 g/dl (20.004 to 20.002; P,0.001) and the excess decline in body mass index was 0.02 kg/m 2 per year (20.02 to 20.01; P,0.001). In patients with diabetes mellitus, there was a yearly excess decline of 0.05 g/dl in albumin (20.09 to 20.02; P=0.002). Compared with women, men had an excess decline of 0.03 g/dl per year in albumin (20.06 to 20.001; P=0.05) and an excess increase of 11.6% per year in IL-6 (0.63%-23.6%; P=0.04).Conclusions Despite guideline-based care, all inflammatory and nutritional parameters worsened over time. The deterioration of some of these parameters was more pronounced in men, older patients, and patients with diabetes mellitus. Special focus on the nutritional status of at-risk patients by individualizing medical care might improve their prognosis.

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Section: Discussionsupporting

confidence: 67%

Clinical Predictors of Decline in Nutritional Parameters over Time in ESRD

Hoedt

Bots

Grooteman

et al. 2014

Clinical Journal of the American Society of Nephrology

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“…Infection and thrombosis rates were higher with AVG compared with AVF; however, access salvage after a thrombotic event was superior with AVG (25). Table 2 provides the outcome data from various studies that evaluated LE-AVG as permanent dialysis vascular access.…”

Section: Long-term Benefits Of Le-avgmentioning

confidence: 99%

Lower Extremity Permanent Dialysis Vascular Access

Parekh

Niyyar

Vachharajani

2016

CJASN

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Hemodialysis remains the most commonly used RRT option around the world. Technological advances, superior access to care, and better quality of care have led to overall improvement in survival of patients on long-term hemodialysis. Maintaining a functioning upper extremity vascular access for a prolonged duration continues to remain a challenge for dialysis providers. Frequently encountered difficulties in clinical practice include (1) a high incidence of central venous catheter-related central vein stenosis and (2) limited options for creating a functioning upper extremity permanent arteriovenous access. Lack of surgical skills, fear of complications, and limited involvement of the treating nephrologists in the decision-making process are some of the reasons why lower extremity permanent dialysis access remains an infrequently used option. Similar to upper extremity vascular access options, lower extremity arteriovenous fistula remains a preferred access over arteriovenous synthetic graft. The use of femoral tunneled catheter as a long-term access should be avoided as far as possible, especially with the availability of newer graft-catheter hybrid devices. Our review provides a summary of clinical evidence published in surgical, radiology, and nephrology literature highlighting the pros and cons of different types of lower extremity permanent dialysis access.

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“…Conduits have been compared in a number of studies but no substantial benefits between different types have been reported 4 . Above all, the function and duration in terms of the emergence of stenotic and thrombotic complications have been monitored [13][14][15][16] . These complications are essentially reparable.…”

Section: Introductionmentioning

confidence: 99%

“…The lowest risk of infectious complications is in patients with native arteriovenous fistula, where the incidence is from 2 to 3% (ref. 13,29,32 ). In patients with arteriovenous graft the incidence of infection is from 11 to 35% (ref.…”

Section: Introductionmentioning

confidence: 99%