PMID: 9423717Jan 10, 1998Paper

Longitudinal comparison of dialysis access methods: risk factors for failure

Journal of Vascular Surgery
T C HodgesJ L Cronenwett

Abstract

To compare dialysis access patency rates and identify risk factors for failure. All access procedures at our institution from 1987 to 1996 were reviewed. Primary procedures were surgically implanted dual-lumen central venous hemodialysis catheters (SIHCs), peritoneal dialysis catheters (PDCs), arteriovenous fistulas (AVFs), and prosthetic shunts (PTFEs). Five hundred eighty-five primary procedures (236 PTFEs, 87 AVFs, 112 SIHCs, and 150 PDCs) and 259 secondary procedures (215 PTFEs, 14 AVFs, 0 SIHCs, and 30 PDCs) were performed on 350 patients. By life table analysis, SIHCs exhibited the lowest primary patency rate (9% at 1 year; p < 0.0001), whereas PDCs had the highest primary patency rate (57% at 1 year; p < 0.02). The primary patency rates of AVFs and PTFEs was similar, with 43% and 41% 1-year patency rates, respectively (p = 0.70). Less-stringent reporting methods would have increased apparent 1-year patency rates by 9% to 41%. With regard to secondary patency, there was no significant difference between PTFEs and PDCs, with 1-year patency rates of 59% and 70%, respectively (p = 0.62), but PTFEs were more frequently revised. In addition, there was no significant difference between AVF and PTFE secondary patency rates, with...Continue Reading

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Citations

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