Comparison of vascular access use in hemodialysis patients in Isfahan in 2003 and 2013

Abstract

Vascular access (VA) complications are the leading cause of morbidity in the hemodialysis (HD) population and responsible for high health care costs. This study was designed to compare the profile of VA use for HD in Isfahan dialysis units in 2003 and 2013. A cross-sectional observational study was conducted between January and March 2013 on 536 HD patients in seven units. The patients data about VA type, number, survival, and demographic characteristics were collected and compared with the data collected in year 2003 on 320 patients in the same city units. The mean age of patients increased from 51 ± 17 to 58 ± 15 years (P < 0.001). The most common etiology of end-stage renal disease was diabetes mellitus, but the percentage increased in 2013 (P = 0.001).The use of an arteriovenous fistula (AVF) as a first dialysis access fell from 60.6% in 2003 to 35.4% in 2013 (P < 0.001). At the time of study, AVFs were used in 92.2% of patients in 2003 versus 56.5% in 2013 (P < 0.001). The 1, 2, 3 and 5 years AVF survival was 80%, 78%, 73%, and 69%, respectively in 2003 versus 79.4%, 61.2%, 47.3%, and 31.5% in 2013. The AVFs proportions decreased and the tunneled catheters proportions increased while the proportion of temporary catheters decreased in 2013 compared with 2003.

The impact of Vascular Access on the Adequacy of Dialysis and the Outcome of the Dialysis Treatment: One Center Experience

“…Results Macedonian authors also suggest that hemodialysis patients have a high number of central venous catheters as vascular access for hemodialysis and significantly higher mortality compared to patients with other vascular access ( 15 ). Similar results who are also observed in some other studies ( 16 , 17 ). Proper care of the catheter, the introduction of algorithms and protocols of treatment should occupy an essential place in each hemodialysis center as a way of prevention and solution of emerging complications ( 17 ).…”

Vascular accesses for hemodialysis in Ceará-Brazil

“…In this context, the rate of fistulas in use in Ceará is higher than that guided by the NKF/DOQI, lower than those found in European and Asian countries. If we make a comparison between economically similar countries, such as India, the state of Ceará-Brazil exceeds the rates of fistulas in use found by Hashidi et al 61 in this country.…”

“…In some countries, the data are conflicting. In India, there was a decrease in patients with fistulas from 92 to 56% between 2003 and 2013, unlike other countries such as Spain and the United States 61 .…”