Vascular access types in patients starting hemodialysis after failed kidney transplant: does close nephrology follow-up matter?
Native arteriovenous fistulae (AVFs) are preferred while central venous catheters (CVCs) are least suitable vascular access (VA) in patients requiring hemodialysis (HD). Unfortunately, around 80% of patients start HD with CVCs. Late referral to nephrologist is thought to be a factor responsible for...
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| Veröffentlicht in: | The journal of vascular access 2017-01, Vol.18 (1), p.22-25 |
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| creator | Haq, Naveed Ul Abdelsalam, Mohamed Said Althaf, Mohammed Mahdi Khormi, Abdulrahman Ali Al Harbi, Hassan Alshamsan, Bader Albaqumi, Mamdouh Nasser Broering, Dieter Clemens Alkorbi, Lutfi Aleid, Hassan Ali |
| description | Native arteriovenous fistulae (AVFs) are preferred while central venous catheters (CVCs) are least suitable vascular access (VA) in patients requiring hemodialysis (HD). Unfortunately, around 80% of patients start HD with CVCs. Late referral to nephrologist is thought to be a factor responsible for this. We retrospectively analyzed the types of VA at HD initiation in renal transplant recipients followed by nephrologists with failed transplant. If early referral to nephrologist improves AVF use, these patients should have higher prevalence of AVF at HD initiation.
All patients who failed their kidney transplants from January 2002 to April 2013 were included in the study. Data regarding planning of VA by nephrologist, documented discussion about renal replacement therapy (RRT), estimated glomerular filtration rate (eGFR) at 6 months and last clinic visit before HD initiation, time of VA referral, and subsequent VA at dialysis initiation were gathered and analyzed.
Eighty-three patients failed their transplants during study period. Data were inaccessible in six patients. Eleven patients started peritoneal dialysis (PD) while 66 started HD. Thirty-two had previous functioning VA while 34 needed VA. There were 11/34 patients (32%) with eGFR |
| doi_str_mv | 10.5301/jva.5000631 |
| format | Article |
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All patients who failed their kidney transplants from January 2002 to April 2013 were included in the study. Data regarding planning of VA by nephrologist, documented discussion about renal replacement therapy (RRT), estimated glomerular filtration rate (eGFR) at 6 months and last clinic visit before HD initiation, time of VA referral, and subsequent VA at dialysis initiation were gathered and analyzed.
Eighty-three patients failed their transplants during study period. Data were inaccessible in six patients. Eleven patients started peritoneal dialysis (PD) while 66 started HD. Thirty-two had previous functioning VA while 34 needed VA. There were 11/34 patients (32%) with eGFR <15 mL/min at six months while 21/34 (61%) had eGFR <15 mL/min at last clinic visit before HD initiation. Only 11/34 (32%) had documented RRT discussion, 8/34 (24%) had VA referral, and 7/34 (21%) had vein mapping. A total of 30/34 (88.3%) started HD with CVC while 4/34 (11.3%) started HD with AVF (p<0.0001).
Early referral to nephrologist by itself may not improve VA care amongst patient with end-stage renal disease.</description><identifier>ISSN: 1129-7298</identifier><identifier>EISSN: 1724-6032</identifier><identifier>DOI: 10.5301/jva.5000631</identifier><identifier>PMID: 27911463</identifier><language>eng</language><publisher>United States</publisher><subject>Adult ; Arteriovenous Shunt, Surgical - adverse effects ; Catheterization, Central Venous - adverse effects ; Female ; Humans ; Kidney Failure, Chronic - diagnosis ; Kidney Failure, Chronic - therapy ; Kidney Transplantation - adverse effects ; Male ; Middle Aged ; Nephrologists ; Nephrology - methods ; Practice Patterns, Physicians ; Quality Improvement ; Quality Indicators, Health Care ; Referral and Consultation ; Renal Dialysis ; Retrospective Studies ; Risk Factors ; Time Factors ; Treatment Failure ; Young Adult</subject><ispartof>The journal of vascular access, 2017-01, Vol.18 (1), p.22-25</ispartof><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c326t-d3900eac74ed9d270c569863ff84c31d8176f9b6e97b4961a463533c160862a53</citedby><cites>FETCH-LOGICAL-c326t-d3900eac74ed9d270c569863ff84c31d8176f9b6e97b4961a463533c160862a53</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27911463$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Haq, Naveed Ul</creatorcontrib><creatorcontrib>Abdelsalam, Mohamed Said</creatorcontrib><creatorcontrib>Althaf, Mohammed Mahdi</creatorcontrib><creatorcontrib>Khormi, Abdulrahman Ali</creatorcontrib><creatorcontrib>Al Harbi, Hassan</creatorcontrib><creatorcontrib>Alshamsan, Bader</creatorcontrib><creatorcontrib>Albaqumi, Mamdouh Nasser</creatorcontrib><creatorcontrib>Broering, Dieter Clemens</creatorcontrib><creatorcontrib>Alkorbi, Lutfi</creatorcontrib><creatorcontrib>Aleid, Hassan Ali</creatorcontrib><title>Vascular access types in patients starting hemodialysis after failed kidney transplant: does close nephrology follow-up matter?</title><title>The journal of vascular access</title><addtitle>J Vasc Access</addtitle><description>Native arteriovenous fistulae (AVFs) are preferred while central venous catheters (CVCs) are least suitable vascular access (VA) in patients requiring hemodialysis (HD). Unfortunately, around 80% of patients start HD with CVCs. Late referral to nephrologist is thought to be a factor responsible for this. We retrospectively analyzed the types of VA at HD initiation in renal transplant recipients followed by nephrologists with failed transplant. If early referral to nephrologist improves AVF use, these patients should have higher prevalence of AVF at HD initiation.
All patients who failed their kidney transplants from January 2002 to April 2013 were included in the study. Data regarding planning of VA by nephrologist, documented discussion about renal replacement therapy (RRT), estimated glomerular filtration rate (eGFR) at 6 months and last clinic visit before HD initiation, time of VA referral, and subsequent VA at dialysis initiation were gathered and analyzed.
Eighty-three patients failed their transplants during study period. Data were inaccessible in six patients. Eleven patients started peritoneal dialysis (PD) while 66 started HD. Thirty-two had previous functioning VA while 34 needed VA. There were 11/34 patients (32%) with eGFR <15 mL/min at six months while 21/34 (61%) had eGFR <15 mL/min at last clinic visit before HD initiation. Only 11/34 (32%) had documented RRT discussion, 8/34 (24%) had VA referral, and 7/34 (21%) had vein mapping. A total of 30/34 (88.3%) started HD with CVC while 4/34 (11.3%) started HD with AVF (p<0.0001).
Early referral to nephrologist by itself may not improve VA care amongst patient with end-stage renal disease.</description><subject>Adult</subject><subject>Arteriovenous Shunt, Surgical - adverse effects</subject><subject>Catheterization, Central Venous - adverse effects</subject><subject>Female</subject><subject>Humans</subject><subject>Kidney Failure, Chronic - diagnosis</subject><subject>Kidney Failure, Chronic - therapy</subject><subject>Kidney Transplantation - adverse effects</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Nephrologists</subject><subject>Nephrology - methods</subject><subject>Practice Patterns, Physicians</subject><subject>Quality Improvement</subject><subject>Quality Indicators, Health Care</subject><subject>Referral and Consultation</subject><subject>Renal Dialysis</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Time Factors</subject><subject>Treatment Failure</subject><subject>Young Adult</subject><issn>1129-7298</issn><issn>1724-6032</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNo9kD1v1jAQgC0Eoh8wda88IqEUfyRO3KWqKgpIlVgoa3SvfWndOnHqc0CZ-tcJ6gvT3fDo0d3D2IkUZ40W8tPDLzhrhBBGy1fsULaqrozQ6vW2S2WrVtnugB0RPQihbCPrt-xAtVbK2uhD9vwTyC0RMgfnkIiXdUbiYeIzlIBTIU4FcgnTHb_HMfkAcaVAHIaCmQ8QInr-GPyEKy8ZJpojTOWc-7RpXEyEfML5PqeY7lY-pBjT72qZ-QhlE1y8Y28GiITv9_OY3V5__nH1tbr5_uXb1eVN5bQypfLaCoHg2hq99aoVrjG2M3oYutpp6TvZmsHuDNp2V1sjYXuu0dpJIzqjoNHH7MOLd87paUEq_RjIYdyOxbRQL7u66ZSQnd3Qjy-oy4ko49DPOYyQ116K_m_xfive74tv9OlevOxG9P_Zf4n1H2dzfgk</recordid><startdate>20170101</startdate><enddate>20170101</enddate><creator>Haq, Naveed Ul</creator><creator>Abdelsalam, Mohamed Said</creator><creator>Althaf, Mohammed Mahdi</creator><creator>Khormi, Abdulrahman Ali</creator><creator>Al Harbi, Hassan</creator><creator>Alshamsan, Bader</creator><creator>Albaqumi, Mamdouh Nasser</creator><creator>Broering, Dieter Clemens</creator><creator>Alkorbi, Lutfi</creator><creator>Aleid, Hassan Ali</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20170101</creationdate><title>Vascular access types in patients starting hemodialysis after failed kidney transplant: does close nephrology follow-up matter?</title><author>Haq, Naveed Ul ; Abdelsalam, Mohamed Said ; Althaf, Mohammed Mahdi ; Khormi, Abdulrahman Ali ; Al Harbi, Hassan ; Alshamsan, Bader ; Albaqumi, Mamdouh Nasser ; Broering, Dieter Clemens ; Alkorbi, Lutfi ; Aleid, Hassan Ali</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c326t-d3900eac74ed9d270c569863ff84c31d8176f9b6e97b4961a463533c160862a53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Adult</topic><topic>Arteriovenous Shunt, Surgical - adverse effects</topic><topic>Catheterization, Central Venous - adverse effects</topic><topic>Female</topic><topic>Humans</topic><topic>Kidney Failure, Chronic - diagnosis</topic><topic>Kidney Failure, Chronic - therapy</topic><topic>Kidney Transplantation - adverse effects</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Nephrologists</topic><topic>Nephrology - methods</topic><topic>Practice Patterns, Physicians</topic><topic>Quality Improvement</topic><topic>Quality Indicators, Health Care</topic><topic>Referral and Consultation</topic><topic>Renal Dialysis</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Time Factors</topic><topic>Treatment Failure</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Haq, Naveed Ul</creatorcontrib><creatorcontrib>Abdelsalam, Mohamed Said</creatorcontrib><creatorcontrib>Althaf, Mohammed Mahdi</creatorcontrib><creatorcontrib>Khormi, Abdulrahman Ali</creatorcontrib><creatorcontrib>Al Harbi, Hassan</creatorcontrib><creatorcontrib>Alshamsan, Bader</creatorcontrib><creatorcontrib>Albaqumi, Mamdouh Nasser</creatorcontrib><creatorcontrib>Broering, Dieter Clemens</creatorcontrib><creatorcontrib>Alkorbi, Lutfi</creatorcontrib><creatorcontrib>Aleid, Hassan Ali</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The journal of vascular access</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Haq, Naveed Ul</au><au>Abdelsalam, Mohamed Said</au><au>Althaf, Mohammed Mahdi</au><au>Khormi, Abdulrahman Ali</au><au>Al Harbi, Hassan</au><au>Alshamsan, Bader</au><au>Albaqumi, Mamdouh Nasser</au><au>Broering, Dieter Clemens</au><au>Alkorbi, Lutfi</au><au>Aleid, Hassan Ali</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Vascular access types in patients starting hemodialysis after failed kidney transplant: does close nephrology follow-up matter?</atitle><jtitle>The journal of vascular access</jtitle><addtitle>J Vasc Access</addtitle><date>2017-01-01</date><risdate>2017</risdate><volume>18</volume><issue>1</issue><spage>22</spage><epage>25</epage><pages>22-25</pages><issn>1129-7298</issn><eissn>1724-6032</eissn><abstract>Native arteriovenous fistulae (AVFs) are preferred while central venous catheters (CVCs) are least suitable vascular access (VA) in patients requiring hemodialysis (HD). Unfortunately, around 80% of patients start HD with CVCs. Late referral to nephrologist is thought to be a factor responsible for this. We retrospectively analyzed the types of VA at HD initiation in renal transplant recipients followed by nephrologists with failed transplant. If early referral to nephrologist improves AVF use, these patients should have higher prevalence of AVF at HD initiation.
All patients who failed their kidney transplants from January 2002 to April 2013 were included in the study. Data regarding planning of VA by nephrologist, documented discussion about renal replacement therapy (RRT), estimated glomerular filtration rate (eGFR) at 6 months and last clinic visit before HD initiation, time of VA referral, and subsequent VA at dialysis initiation were gathered and analyzed.
Eighty-three patients failed their transplants during study period. Data were inaccessible in six patients. Eleven patients started peritoneal dialysis (PD) while 66 started HD. Thirty-two had previous functioning VA while 34 needed VA. There were 11/34 patients (32%) with eGFR <15 mL/min at six months while 21/34 (61%) had eGFR <15 mL/min at last clinic visit before HD initiation. Only 11/34 (32%) had documented RRT discussion, 8/34 (24%) had VA referral, and 7/34 (21%) had vein mapping. A total of 30/34 (88.3%) started HD with CVC while 4/34 (11.3%) started HD with AVF (p<0.0001).
Early referral to nephrologist by itself may not improve VA care amongst patient with end-stage renal disease.</abstract><cop>United States</cop><pmid>27911463</pmid><doi>10.5301/jva.5000631</doi><tpages>4</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | The journal of vascular access, 2017-01, Vol.18 (1), p.22-25 |
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| source | SAGE Complete A-Z List; MEDLINE |
| subjects | Adult Arteriovenous Shunt, Surgical - adverse effects Catheterization, Central Venous - adverse effects Female Humans Kidney Failure, Chronic - diagnosis Kidney Failure, Chronic - therapy Kidney Transplantation - adverse effects Male Middle Aged Nephrologists Nephrology - methods Practice Patterns, Physicians Quality Improvement Quality Indicators, Health Care Referral and Consultation Renal Dialysis Retrospective Studies Risk Factors Time Factors Treatment Failure Young Adult |
| title | Vascular access types in patients starting hemodialysis after failed kidney transplant: does close nephrology follow-up matter? |
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