Complications of Vascular Access for Hemodialysis

Winsett, O. E.; Wolma, Fred J.

doi:10.1097/00007611-198505000-00004

Cited by 122 publications

(49 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Once an AVF is matured, the revision rate ranges from 0.17 to 0.57 (20,21,(73)(74)(75) and is required in approximately 50% of AVF (32,76). This contrasts to fewer interventions for graft maturation, whereas the revisions required for grafts per access year ranges between 0.44 and 1.80 (20,21,73,75,77) (typically three to six rimes greater than for AVF). In balance, whereas fistulas require up to three times more interventions for maturation, grafts can require up to six times more interventions for maintenance to achieve similar cumulative survival ( Figure 6).…”

Section: Impact On the Patient: The Patient Is Firstmentioning

confidence: 99%

Fistula First Initiative

Lok¹

2007

Clinical Journal of the American Society of Nephrology

276

231

View full text Add to dashboard Cite

Section: Impact On the Patient: The Patient Is Firstmentioning

confidence: 99%

Fistula First Initiative

Lok¹

2007

Clinical Journal of the American Society of Nephrology

276

231

View full text Add to dashboard Cite

“…In patients who have exhausted all options for an upper extremity fistula or graft, placement of a thigh graft is a viable option (3,4). Although thrombosis is the most common complication of grafts, infection is also relatively frequent, affecting 9% to 20% of grafts (5)(6)(7)(8)(9)(10)(11). Graft infections can result in long hospitalizations, serious complications, and prolonged catheter dependence (12).…”

Section: Introductionmentioning

confidence: 99%

Arteriovenous Graft Infection

Harish

Allon

2011

Clinical Journal of the American Society of Nephrology

View full text Add to dashboard Cite

SummaryBackground and objectives There are a limited number of publications on the features of arteriovenous graft infection in hemodialysis patients. The authors compared the clinical presentation, complications, and outcomes of infections of thigh and upper extremity grafts.Design, setting, participants, & measurements The authors queried a prospective access database at a large university medical center and identified 132 patients with graft infections (40 in the thigh and 92 in the upper extremity) requiring surgical excision. The authors collected information regarding the microbiology, complications, and clinical outcomes. ResultsThe two graft groups were similar in age, gender, race, and frequency of diabetes. The median age of infected grafts was 162 days for thigh grafts versus 168 days for upper extremity grafts (P ϭ 0.35). Thigh graft infections were more likely than upper extremity graft infections to be caused by a Gram-negative rod (31% versus 4%; P ϭ 0.003), and more likely to result in a metastatic infection (15% versus 3%; P ϭ 0.02). The duration of hospitalization associated with graft infection was similar (10.8 Ϯ 5.4 versus 8.7 Ϯ 6.3 days; P ϭ 0.09). Finally, median catheter dependence was longer after thigh graft than upper arm graft infections (319 versus 237 days; P ϭ 0.04).Conclusions As compared with upper extremity graft infections, thigh graft infections requiring excision are more likely to be caused by Gram-negative bacteria and to result in serious metastatic complications. These differences may require different empiric antibiotics and a higher index of suspicion for infection in hemodialysis patients with thigh grafts.

show abstract

“…There are limited data in the literature regarding morbidity associated with a vascular access [5][6][7][8][9], The purpose of this study was to evaluate long-term survival o f vascular accesses in a chronic hemodialysis pop ulation who had been on dialysis for more than 2 years.…”

mentioning

confidence: 99%

Long-Term Survival of Vascular Accesses in a Large Chronic Hemodialysis Population

Chazan

London²,

Pono³

1995

Nephron

View full text Add to dashboard Cite

Complications associated with vascular accesses account for approximately 30% of hospital admissions for chronic hemodialysis patients. Long-term patency of access was evaluated in 76 patients, without diabetes mellitus, who had been on dialysis for at least 3 years and 41 patients, with diabetes mellitus, who had been on dialysis for over 2 years. Fistulas functioned longer than grafts (58 vs. 22 months, p < 0.01, in nondiabetics and 70 vs 22 months, p < 0.01, in patients with diabetes). Declotting or revision of restored graft function for short periods of time ( < 6-10 months) and subsequent declotting was ineffective. Infections were uncommon in grafts (1 per 13.5 years of dialysis) and in fistulas (1 in 200 years of dialysis).

show abstract

Complications of Vascular Access for Hemodialysis

Cited by 122 publications

References 0 publications

Fistula First Initiative

Fistula First Initiative

Arteriovenous Graft Infection

Long-Term Survival of Vascular Accesses in a Large Chronic Hemodialysis Population

Contact Info

Product

Resources

About