Patients on hemodialysis are better served by a proximal arteriovenous fistula for long-term venous access.

Hdl Handle:
http://hdl.handle.net/10147/292104
Title:
Patients on hemodialysis are better served by a proximal arteriovenous fistula for long-term venous access.
Authors:
Sultan, Sherif; Hynes, Niamh; Hamada, Nader; Tawfick, Wael
Affiliation:
Department of Vascular and Endovascular Surgery, Western Vascular Institute, Galway University Hospital, Galway, Ireland. sherif.sultan@hse.ie
Citation:
Patients on hemodialysis are better served by a proximal arteriovenous fistula for long-term venous access. 2012, 46 (8):624-34 Vasc Endovascular Surg
Journal:
Vascular and endovascular surgery
Issue Date:
Nov-2012
URI:
http://hdl.handle.net/10147/292104
DOI:
10.1177/1538574412462635
PubMed ID:
23064823
Abstract:
Patients with end-stage renal disease should have arteriovenous fistula (AVF) formation 3 to 6 months prior to commencing hemodialysis (HD). However, this is not always possible with strained health care resources. We aim to compare autologous proximal AVF (PAVF) with distal AVF (DAVF) in patients already on HD. Primary end point is 4-year functional primary. Secondary end point is freedom from major adverse clinical events (MACEs). From January 2003 to June 2009, out of 495 AVF formations, 179 (36%) patients were already on HD. These patients had 200 AVF formations (49 DAVF vs 151 PAVF) in arms in which no previous fistula had been formed. No synthetic graft was used. Four-year primary functional patency significantly improved with PAVF (68.9% ± SD 8.8%) compared to DAVF (7.3% ± SD 4.9%; P < .0001). Five-year freedom from MACE was 85% with PAVF compared to 40% with DAVF (P < .005). Proximal AVF bestows long-term functional access with fewer complications compared to DAVF for patients already on HD.
Item Type:
Article
Language:
en
Keywords:
KIDNEY DISEASE
MeSH:
Adult; Aged; Aged, 80 and over; Arteriovenous Shunt, Surgical; Chi-Square Distribution; Disease-Free Survival; Female; Humans; Kaplan-Meier Estimate; Kidney Failure, Chronic; Male; Middle Aged; Postoperative Complications; Proportional Hazards Models; Renal Dialysis; Time Factors; Treatment Outcome; Upper Extremity; Vascular Patency
ISSN:
1938-9116

Full metadata record

DC FieldValue Language
dc.contributor.authorSultan, Sherifen_GB
dc.contributor.authorHynes, Niamhen_GB
dc.contributor.authorHamada, Naderen_GB
dc.contributor.authorTawfick, Waelen_GB
dc.date.accessioned2013-05-16T15:32:37Z-
dc.date.available2013-05-16T15:32:37Z-
dc.date.issued2012-11-
dc.identifier.citationPatients on hemodialysis are better served by a proximal arteriovenous fistula for long-term venous access. 2012, 46 (8):624-34 Vasc Endovascular Surgen_GB
dc.identifier.issn1938-9116-
dc.identifier.pmid23064823-
dc.identifier.doi10.1177/1538574412462635-
dc.identifier.urihttp://hdl.handle.net/10147/292104-
dc.description.abstractPatients with end-stage renal disease should have arteriovenous fistula (AVF) formation 3 to 6 months prior to commencing hemodialysis (HD). However, this is not always possible with strained health care resources. We aim to compare autologous proximal AVF (PAVF) with distal AVF (DAVF) in patients already on HD. Primary end point is 4-year functional primary. Secondary end point is freedom from major adverse clinical events (MACEs). From January 2003 to June 2009, out of 495 AVF formations, 179 (36%) patients were already on HD. These patients had 200 AVF formations (49 DAVF vs 151 PAVF) in arms in which no previous fistula had been formed. No synthetic graft was used. Four-year primary functional patency significantly improved with PAVF (68.9% ± SD 8.8%) compared to DAVF (7.3% ± SD 4.9%; P < .0001). Five-year freedom from MACE was 85% with PAVF compared to 40% with DAVF (P < .005). Proximal AVF bestows long-term functional access with fewer complications compared to DAVF for patients already on HD.en_GB
dc.language.isoenen
dc.rightsArchived with thanks to Vascular and endovascular surgeryen_GB
dc.subjectKIDNEY DISEASE-
dc.subject.meshAdult-
dc.subject.meshAged-
dc.subject.meshAged, 80 and over-
dc.subject.meshArteriovenous Shunt, Surgical-
dc.subject.meshChi-Square Distribution-
dc.subject.meshDisease-Free Survival-
dc.subject.meshFemale-
dc.subject.meshHumans-
dc.subject.meshKaplan-Meier Estimate-
dc.subject.meshKidney Failure, Chronic-
dc.subject.meshMale-
dc.subject.meshMiddle Aged-
dc.subject.meshPostoperative Complications-
dc.subject.meshProportional Hazards Models-
dc.subject.meshRenal Dialysis-
dc.subject.meshTime Factors-
dc.subject.meshTreatment Outcome-
dc.subject.meshUpper Extremity-
dc.subject.meshVascular Patency-
dc.titlePatients on hemodialysis are better served by a proximal arteriovenous fistula for long-term venous access.en_GB
dc.typeArticleen
dc.contributor.departmentDepartment of Vascular and Endovascular Surgery, Western Vascular Institute, Galway University Hospital, Galway, Ireland. sherif.sultan@hse.ieen_GB
dc.identifier.journalVascular and endovascular surgeryen_GB
dc.description.provinceConnachten

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