Haemoglobin level and vascular access survival in haemodialysis patients
Background. A full correction of anaemia in haemodialysis (HD) patients may lead to an increased risk of vascular access (VA) failure. We studied the relationship between haemoglobin (Hb) level and VA survival. Methods. Incident patients between January 2000 and December 2002 with 65 years (RR: 1.32...
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| Veröffentlicht in: | Nephrology, dialysis, transplantation dialysis, transplantation, 2005-11, Vol.20 (11), p.2453-2457 |
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| creator | Garrancho, José M. Kirchgessner, Judith Arranz, Mariana Klinkner, Gerdi Rentero, Ramón Ayala, Juan A. Marcelli, Daniele |
| description | Background. A full correction of anaemia in haemodialysis (HD) patients may lead to an increased risk of vascular access (VA) failure. We studied the relationship between haemoglobin (Hb) level and VA survival. Methods. Incident patients between January 2000 and December 2002 with 65 years (RR: 1.32; P = 0.11) and iPTH (RR: 1.56; P = 0.01) were identified as predictive factors for VA failure; ACE inhibitors or ARB (RR: 0.69; P = 0.03) were found to be protective factors. Conclusions. In the studied population, the correction of Hb level to >12 g/dl was not associated with a higher incidence of VA thrombosis than in patients with Hb between 10 and 12 g/dl. ACE inhibitors or ARBs were found to be protective factors, and diabetes, age >65 years and iPTH >400 pg/ml were negative predictive factors for VA survival. |
| doi_str_mv | 10.1093/ndt/gfi027 |
| format | Article |
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A full correction of anaemia in haemodialysis (HD) patients may lead to an increased risk of vascular access (VA) failure. We studied the relationship between haemoglobin (Hb) level and VA survival. Methods. Incident patients between January 2000 and December 2002 with <1 month on HD were considered. The relative risk (RR) of access failure was evaluated in four different groups of patients divided according to their Hb level (<10, 10–12, 12–13 and >13 g/dl). Other factors possibly influencing VA survival were also considered: age, gender, diabetes, vascular disease, intact parathyroid hormone (iPTH) and treatment with an angiotensin-converting enzyme (ACE) inhibitor, angiotensin receptor blocker (ARB) or recombinant human erythropoeitin therapy. Results. We studied 1254 patients (1057 with autologous fistulae, 75 grafts and 122 permanent catheters at admission). Based on Cox analysis, we found the next statistically significant RR of VA failure to be 2.3 times higher with grafts than with arterio-venous fistulae (AVFs) and 1.8 times higher in AVFs with Hb <10 g/dl than in AVFs of the next Hb group. There was no statistically significant difference in the RR of VA failure between patients with Hb 10–12 g/dl and those with Hb 12–13 g/dl or >13 g/dl. Diabetes (RR: 1.41, P = 0.06), age >65 years (RR: 1.32; P = 0.11) and iPTH (RR: 1.56; P = 0.01) were identified as predictive factors for VA failure; ACE inhibitors or ARB (RR: 0.69; P = 0.03) were found to be protective factors. Conclusions. In the studied population, the correction of Hb level to >12 g/dl was not associated with a higher incidence of VA thrombosis than in patients with Hb between 10 and 12 g/dl. ACE inhibitors or ARBs were found to be protective factors, and diabetes, age >65 years and iPTH >400 pg/ml were negative predictive factors for VA survival.</description><identifier>ISSN: 0931-0509</identifier><identifier>EISSN: 1460-2385</identifier><identifier>DOI: 10.1093/ndt/gfi027</identifier><identifier>PMID: 16077146</identifier><identifier>CODEN: NDTREA</identifier><language>eng</language><publisher>Oxford: Oxford University Press</publisher><subject>ACE inhibitors ; Aged ; anemia correction ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Arteriovenous Shunt, Surgical - instrumentation ; Biological and medical sciences ; Biomarkers - blood ; Catheters, Indwelling ; Diabetes Mellitus ; Emergency and intensive care: renal failure. Dialysis management ; Equipment Failure ; Female ; Follow-Up Studies ; haemoglobin ; Hemoglobins - metabolism ; Humans ; Intensive care medicine ; iPTH ; Kidney Failure, Chronic - blood ; Kidney Failure, Chronic - therapy ; Male ; Medical sciences ; Parathyroid Hormone - blood ; Predictive Value of Tests ; Prognosis ; Prospective Studies ; Renal Dialysis - methods ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Surgery of the urinary system ; vascular access ; Vascular surgery: aorta, extremities, vena cava. Surgery of the lymphatic vessels</subject><ispartof>Nephrology, dialysis, transplantation, 2005-11, Vol.20 (11), p.2453-2457</ispartof><rights>2005 INIST-CNRS</rights><rights>Copyright Oxford University Press(England) Nov 2005</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c380t-6b1a774073ccbbea592146fade9ce5e5934cf3f6205a37f912508d6407ae44a93</citedby><cites>FETCH-LOGICAL-c380t-6b1a774073ccbbea592146fade9ce5e5934cf3f6205a37f912508d6407ae44a93</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=17262737$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/16077146$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Garrancho, José M.</creatorcontrib><creatorcontrib>Kirchgessner, Judith</creatorcontrib><creatorcontrib>Arranz, Mariana</creatorcontrib><creatorcontrib>Klinkner, Gerdi</creatorcontrib><creatorcontrib>Rentero, Ramón</creatorcontrib><creatorcontrib>Ayala, Juan A.</creatorcontrib><creatorcontrib>Marcelli, Daniele</creatorcontrib><title>Haemoglobin level and vascular access survival in haemodialysis patients</title><title>Nephrology, dialysis, transplantation</title><addtitle>Nephrol. Dial. Transplant</addtitle><description>Background. A full correction of anaemia in haemodialysis (HD) patients may lead to an increased risk of vascular access (VA) failure. We studied the relationship between haemoglobin (Hb) level and VA survival. Methods. Incident patients between January 2000 and December 2002 with <1 month on HD were considered. The relative risk (RR) of access failure was evaluated in four different groups of patients divided according to their Hb level (<10, 10–12, 12–13 and >13 g/dl). Other factors possibly influencing VA survival were also considered: age, gender, diabetes, vascular disease, intact parathyroid hormone (iPTH) and treatment with an angiotensin-converting enzyme (ACE) inhibitor, angiotensin receptor blocker (ARB) or recombinant human erythropoeitin therapy. Results. We studied 1254 patients (1057 with autologous fistulae, 75 grafts and 122 permanent catheters at admission). Based on Cox analysis, we found the next statistically significant RR of VA failure to be 2.3 times higher with grafts than with arterio-venous fistulae (AVFs) and 1.8 times higher in AVFs with Hb <10 g/dl than in AVFs of the next Hb group. There was no statistically significant difference in the RR of VA failure between patients with Hb 10–12 g/dl and those with Hb 12–13 g/dl or >13 g/dl. Diabetes (RR: 1.41, P = 0.06), age >65 years (RR: 1.32; P = 0.11) and iPTH (RR: 1.56; P = 0.01) were identified as predictive factors for VA failure; ACE inhibitors or ARB (RR: 0.69; P = 0.03) were found to be protective factors. Conclusions. In the studied population, the correction of Hb level to >12 g/dl was not associated with a higher incidence of VA thrombosis than in patients with Hb between 10 and 12 g/dl. ACE inhibitors or ARBs were found to be protective factors, and diabetes, age >65 years and iPTH >400 pg/ml were negative predictive factors for VA survival.</description><subject>ACE inhibitors</subject><subject>Aged</subject><subject>anemia correction</subject><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>Arteriovenous Shunt, Surgical - instrumentation</subject><subject>Biological and medical sciences</subject><subject>Biomarkers - blood</subject><subject>Catheters, Indwelling</subject><subject>Diabetes Mellitus</subject><subject>Emergency and intensive care: renal failure. Dialysis management</subject><subject>Equipment Failure</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>haemoglobin</subject><subject>Hemoglobins - metabolism</subject><subject>Humans</subject><subject>Intensive care medicine</subject><subject>iPTH</subject><subject>Kidney Failure, Chronic - blood</subject><subject>Kidney Failure, Chronic - therapy</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Parathyroid Hormone - blood</subject><subject>Predictive Value of Tests</subject><subject>Prognosis</subject><subject>Prospective Studies</subject><subject>Renal Dialysis - methods</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><subject>Surgery of the urinary system</subject><subject>vascular access</subject><subject>Vascular surgery: aorta, extremities, vena cava. Surgery of the lymphatic vessels</subject><issn>0931-0509</issn><issn>1460-2385</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2005</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpd0E1rFEEQBuAmKMkaveQHhEHQgzCmv3v6mAR1hQWDKAQvTU1PT-zYO7PpmlnMv08vuxjwVId66qV4CTlj9COjVlwM3XRx10fKzRFZMKlpzUWjXpBFWbKaKmpPyCvEe0qp5cYckxOmqTFFLshyCWE93qWxjUOVwjakCoau2gL6OUGuwPuAWOGct3ELqSrq9-6ii5AeMWK1gSmGYcLX5GUPCcObwzwlPz9_-nG9rFffvny9vlzVXjR0qnXLwBhJjfC-bQMoy8sfPXTB-qCCskL6XvSaUwXC9JZxRZtOlwMIUoIVp-T9PneTx4c54OTWEX1ICYYwzuh0oxuplSzw7X_wfpzzUH5znDVMCit5QR_2yOcRMYfebXJcQ350jLpdua6U6_blFnx-SJzbdeie6aHNAt4dQKkPUp9h8BGfneG6xOyC6r2LOIW___aQ_zhd9sotb385qe3NFb9due_iCV9Bkao</recordid><startdate>20051101</startdate><enddate>20051101</enddate><creator>Garrancho, José M.</creator><creator>Kirchgessner, Judith</creator><creator>Arranz, Mariana</creator><creator>Klinkner, Gerdi</creator><creator>Rentero, Ramón</creator><creator>Ayala, Juan A.</creator><creator>Marcelli, Daniele</creator><general>Oxford University Press</general><general>Oxford Publishing Limited (England)</general><scope>BSCLL</scope><scope>IQODW</scope><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>7QP</scope><scope>7T5</scope><scope>H94</scope><scope>K9.</scope><scope>7X8</scope></search><sort><creationdate>20051101</creationdate><title>Haemoglobin level and vascular access survival in haemodialysis patients</title><author>Garrancho, José M. ; Kirchgessner, Judith ; Arranz, Mariana ; Klinkner, Gerdi ; Rentero, Ramón ; Ayala, Juan A. ; Marcelli, Daniele</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c380t-6b1a774073ccbbea592146fade9ce5e5934cf3f6205a37f912508d6407ae44a93</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2005</creationdate><topic>ACE inhibitors</topic><topic>Aged</topic><topic>anemia correction</topic><topic>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</topic><topic>Arteriovenous Shunt, Surgical - instrumentation</topic><topic>Biological and medical sciences</topic><topic>Biomarkers - blood</topic><topic>Catheters, Indwelling</topic><topic>Diabetes Mellitus</topic><topic>Emergency and intensive care: renal failure. Dialysis management</topic><topic>Equipment Failure</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>haemoglobin</topic><topic>Hemoglobins - metabolism</topic><topic>Humans</topic><topic>Intensive care medicine</topic><topic>iPTH</topic><topic>Kidney Failure, Chronic - blood</topic><topic>Kidney Failure, Chronic - therapy</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Parathyroid Hormone - blood</topic><topic>Predictive Value of Tests</topic><topic>Prognosis</topic><topic>Prospective Studies</topic><topic>Renal Dialysis - methods</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><topic>Surgery of the urinary system</topic><topic>vascular access</topic><topic>Vascular surgery: aorta, extremities, vena cava. Surgery of the lymphatic vessels</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Garrancho, José M.</creatorcontrib><creatorcontrib>Kirchgessner, Judith</creatorcontrib><creatorcontrib>Arranz, Mariana</creatorcontrib><creatorcontrib>Klinkner, Gerdi</creatorcontrib><creatorcontrib>Rentero, Ramón</creatorcontrib><creatorcontrib>Ayala, Juan A.</creatorcontrib><creatorcontrib>Marcelli, Daniele</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Immunology Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Nephrology, dialysis, transplantation</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Garrancho, José M.</au><au>Kirchgessner, Judith</au><au>Arranz, Mariana</au><au>Klinkner, Gerdi</au><au>Rentero, Ramón</au><au>Ayala, Juan A.</au><au>Marcelli, Daniele</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Haemoglobin level and vascular access survival in haemodialysis patients</atitle><jtitle>Nephrology, dialysis, transplantation</jtitle><addtitle>Nephrol. Dial. Transplant</addtitle><date>2005-11-01</date><risdate>2005</risdate><volume>20</volume><issue>11</issue><spage>2453</spage><epage>2457</epage><pages>2453-2457</pages><issn>0931-0509</issn><eissn>1460-2385</eissn><coden>NDTREA</coden><abstract>Background. A full correction of anaemia in haemodialysis (HD) patients may lead to an increased risk of vascular access (VA) failure. We studied the relationship between haemoglobin (Hb) level and VA survival. Methods. Incident patients between January 2000 and December 2002 with <1 month on HD were considered. The relative risk (RR) of access failure was evaluated in four different groups of patients divided according to their Hb level (<10, 10–12, 12–13 and >13 g/dl). Other factors possibly influencing VA survival were also considered: age, gender, diabetes, vascular disease, intact parathyroid hormone (iPTH) and treatment with an angiotensin-converting enzyme (ACE) inhibitor, angiotensin receptor blocker (ARB) or recombinant human erythropoeitin therapy. Results. We studied 1254 patients (1057 with autologous fistulae, 75 grafts and 122 permanent catheters at admission). Based on Cox analysis, we found the next statistically significant RR of VA failure to be 2.3 times higher with grafts than with arterio-venous fistulae (AVFs) and 1.8 times higher in AVFs with Hb <10 g/dl than in AVFs of the next Hb group. There was no statistically significant difference in the RR of VA failure between patients with Hb 10–12 g/dl and those with Hb 12–13 g/dl or >13 g/dl. Diabetes (RR: 1.41, P = 0.06), age >65 years (RR: 1.32; P = 0.11) and iPTH (RR: 1.56; P = 0.01) were identified as predictive factors for VA failure; ACE inhibitors or ARB (RR: 0.69; P = 0.03) were found to be protective factors. Conclusions. In the studied population, the correction of Hb level to >12 g/dl was not associated with a higher incidence of VA thrombosis than in patients with Hb between 10 and 12 g/dl. ACE inhibitors or ARBs were found to be protective factors, and diabetes, age >65 years and iPTH >400 pg/ml were negative predictive factors for VA survival.</abstract><cop>Oxford</cop><pub>Oxford University Press</pub><pmid>16077146</pmid><doi>10.1093/ndt/gfi027</doi><tpages>5</tpages></addata></record> |
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| source | MEDLINE; Oxford University Press Journals All Titles (1996-Current); EZB-FREE-00999 freely available EZB journals; Alma/SFX Local Collection |
| subjects | ACE inhibitors Aged anemia correction Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Arteriovenous Shunt, Surgical - instrumentation Biological and medical sciences Biomarkers - blood Catheters, Indwelling Diabetes Mellitus Emergency and intensive care: renal failure. Dialysis management Equipment Failure Female Follow-Up Studies haemoglobin Hemoglobins - metabolism Humans Intensive care medicine iPTH Kidney Failure, Chronic - blood Kidney Failure, Chronic - therapy Male Medical sciences Parathyroid Hormone - blood Predictive Value of Tests Prognosis Prospective Studies Renal Dialysis - methods Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Surgery of the urinary system vascular access Vascular surgery: aorta, extremities, vena cava. Surgery of the lymphatic vessels |
| title | Haemoglobin level and vascular access survival in haemodialysis patients |
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