The Longevity of Arteriovenous Graft for Hemodialysis Patients—Externally Supported or Nonsupported
Because thrombosis and stenosis are the most frequent causes of arteriovenous graft (AVG) failure, several externally supported grafts were designed to enhance incompressibility and kinking resistance to improve the patency. However, consensus on advantage of these modifications having still not bee...
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Veröffentlicht in: | Clinical journal of the American Society of Nephrology 2010-06, Vol.5 (6), p.1029-1035 |
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description | Because thrombosis and stenosis are the most frequent causes of arteriovenous graft (AVG) failure, several externally supported grafts were designed to enhance incompressibility and kinking resistance to improve the patency. However, consensus on advantage of these modifications having still not been reached might relate to the previous limited patient numbers and small studies. This study analyzed the longevity of externally supported and nonsupported AVG on the basis of the nationwide database to understand whether the externally supported design could improve the duration of patency of AVG.
Adult incident patients (n = 4402) were retrospectively enrolled who had began hemodialysis between January 1, 2002 and December 31, 2005. All incident patients with AVG, before or after beginning regular hemodialysis, between January 1, 2000 and December 31, 2006 were identified. The Cox proportional hazard model was used to compare the longevity of externally supported and nonsupported AVG by controlling other covariates.
There were 990 patients with externally supported AVG and 3412 patients with nonsupported AVG. The patency rates of externally supported AVG were 49.4%, 31.6%, and 20.2% at 1, 2 and 3 years, respectively; those of nonsupported AVG were 31.9%, 17.4%, and 10.8%. The survival of nonsupported AVG was significantly inferior to that of externally supported AVG.
Externally supported AVG are superior to nonsupported AVG for long-term patency. The incompressibility and kinking resistance of ringed grafts may shed light on a direction for the future development of dialysis graft design. |
doi_str_mv | 10.2215/CJN.08181109 |
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Adult incident patients (n = 4402) were retrospectively enrolled who had began hemodialysis between January 1, 2002 and December 31, 2005. All incident patients with AVG, before or after beginning regular hemodialysis, between January 1, 2000 and December 31, 2006 were identified. The Cox proportional hazard model was used to compare the longevity of externally supported and nonsupported AVG by controlling other covariates.
There were 990 patients with externally supported AVG and 3412 patients with nonsupported AVG. The patency rates of externally supported AVG were 49.4%, 31.6%, and 20.2% at 1, 2 and 3 years, respectively; those of nonsupported AVG were 31.9%, 17.4%, and 10.8%. The survival of nonsupported AVG was significantly inferior to that of externally supported AVG.
Externally supported AVG are superior to nonsupported AVG for long-term patency. The incompressibility and kinking resistance of ringed grafts may shed light on a direction for the future development of dialysis graft design.</description><identifier>ISSN: 1555-9041</identifier><identifier>EISSN: 1555-905X</identifier><identifier>DOI: 10.2215/CJN.08181109</identifier><identifier>PMID: 20378642</identifier><language>eng</language><publisher>United States: American Society of Nephrology</publisher><subject>Adolescent ; Adult ; Aged ; Arteriovenous Shunt, Surgical - adverse effects ; Arteriovenous Shunt, Surgical - instrumentation ; Blood Vessel Prosthesis ; Blood Vessel Prosthesis Implantation - adverse effects ; Blood Vessel Prosthesis Implantation - instrumentation ; Chi-Square Distribution ; Female ; Graft Occlusion, Vascular - etiology ; Graft Occlusion, Vascular - physiopathology ; Graft Occlusion, Vascular - prevention & control ; Humans ; Male ; Middle Aged ; Original ; Proportional Hazards Models ; Prosthesis Design ; Renal Dialysis ; Retrospective Studies ; Risk Assessment ; Risk Factors ; Taiwan ; Time Factors ; Treatment Outcome ; Upper Extremity - blood supply ; Vascular Patency ; Young Adult</subject><ispartof>Clinical journal of the American Society of Nephrology, 2010-06, Vol.5 (6), p.1029-1035</ispartof><rights>Copyright © 2010 by the American Society of Nephrology</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c415t-d6e25e657e3a41750963fd84fba281160004571e67d4d9e4c0dee365c4a18c2f3</citedby><cites>FETCH-LOGICAL-c415t-d6e25e657e3a41750963fd84fba281160004571e67d4d9e4c0dee365c4a18c2f3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC2879306/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC2879306/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,727,780,784,885,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/20378642$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hung, Yen-Ni</creatorcontrib><creatorcontrib>Ko, Po-Jen</creatorcontrib><creatorcontrib>Ng, Yee-Yung</creatorcontrib><creatorcontrib>Wu, Shiao-Chi</creatorcontrib><title>The Longevity of Arteriovenous Graft for Hemodialysis Patients—Externally Supported or Nonsupported</title><title>Clinical journal of the American Society of Nephrology</title><addtitle>Clin J Am Soc Nephrol</addtitle><description>Because thrombosis and stenosis are the most frequent causes of arteriovenous graft (AVG) failure, several externally supported grafts were designed to enhance incompressibility and kinking resistance to improve the patency. However, consensus on advantage of these modifications having still not been reached might relate to the previous limited patient numbers and small studies. This study analyzed the longevity of externally supported and nonsupported AVG on the basis of the nationwide database to understand whether the externally supported design could improve the duration of patency of AVG.
Adult incident patients (n = 4402) were retrospectively enrolled who had began hemodialysis between January 1, 2002 and December 31, 2005. All incident patients with AVG, before or after beginning regular hemodialysis, between January 1, 2000 and December 31, 2006 were identified. The Cox proportional hazard model was used to compare the longevity of externally supported and nonsupported AVG by controlling other covariates.
There were 990 patients with externally supported AVG and 3412 patients with nonsupported AVG. The patency rates of externally supported AVG were 49.4%, 31.6%, and 20.2% at 1, 2 and 3 years, respectively; those of nonsupported AVG were 31.9%, 17.4%, and 10.8%. The survival of nonsupported AVG was significantly inferior to that of externally supported AVG.
Externally supported AVG are superior to nonsupported AVG for long-term patency. The incompressibility and kinking resistance of ringed grafts may shed light on a direction for the future development of dialysis graft design.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Arteriovenous Shunt, Surgical - adverse effects</subject><subject>Arteriovenous Shunt, Surgical - instrumentation</subject><subject>Blood Vessel Prosthesis</subject><subject>Blood Vessel Prosthesis Implantation - adverse effects</subject><subject>Blood Vessel Prosthesis Implantation - instrumentation</subject><subject>Chi-Square Distribution</subject><subject>Female</subject><subject>Graft Occlusion, Vascular - etiology</subject><subject>Graft Occlusion, Vascular - physiopathology</subject><subject>Graft Occlusion, Vascular - prevention & control</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Original</subject><subject>Proportional Hazards Models</subject><subject>Prosthesis Design</subject><subject>Renal Dialysis</subject><subject>Retrospective Studies</subject><subject>Risk Assessment</subject><subject>Risk Factors</subject><subject>Taiwan</subject><subject>Time Factors</subject><subject>Treatment Outcome</subject><subject>Upper Extremity - blood supply</subject><subject>Vascular Patency</subject><subject>Young Adult</subject><issn>1555-9041</issn><issn>1555-905X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2010</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpVkctOwzAQRS0E4r1jjbxjQ4vfSTZIqAIKqgCJIrGz3GTSGiVxsdNCd3wEX8iXYAQtsPJYc-bO4yJ0QEmXMSpPetc3XZLSlFKSraFtKqXsZEQ-rq9iQbfQTghPhAjBmdxEW4zwJFWCbSMYTgAPXDOGuW0X2JX4zLfgrZtD42YBX3pTtrh0HvehdoU11SLYgO9Ma6Fpw8fb-_lr5BtTVQt8P5tOXSwvcORvXBOW_z20UZoqwP7Pu4seLs6HvX5ncHt51TsbdHJBZdspFDAJSibAjaCJJJniZZGKcmRY3E-RuIFMKKikEEUGIicFAFcyF4amOSv5Ljr91p3ORjUUeRzRm0pPva2NX2hnrP6faexEj91cszTJOFFR4OhHwLvnGYRW1zbkUFWmgXgOnXDORJYmIpLH32TuXQgeylUXSvSXMToao5fGRPzw72QreOnEb-eJHU9erAcd6njUiDOdP5nQSK2iNMv4J4bvmj8</recordid><startdate>20100601</startdate><enddate>20100601</enddate><creator>Hung, Yen-Ni</creator><creator>Ko, Po-Jen</creator><creator>Ng, Yee-Yung</creator><creator>Wu, Shiao-Chi</creator><general>American Society of Nephrology</general><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><scope>5PM</scope></search><sort><creationdate>20100601</creationdate><title>The Longevity of Arteriovenous Graft for Hemodialysis Patients—Externally Supported or Nonsupported</title><author>Hung, Yen-Ni ; Ko, Po-Jen ; Ng, Yee-Yung ; Wu, Shiao-Chi</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c415t-d6e25e657e3a41750963fd84fba281160004571e67d4d9e4c0dee365c4a18c2f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2010</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Arteriovenous Shunt, Surgical - adverse effects</topic><topic>Arteriovenous Shunt, Surgical - instrumentation</topic><topic>Blood Vessel Prosthesis</topic><topic>Blood Vessel Prosthesis Implantation - adverse effects</topic><topic>Blood Vessel Prosthesis Implantation - instrumentation</topic><topic>Chi-Square Distribution</topic><topic>Female</topic><topic>Graft Occlusion, Vascular - etiology</topic><topic>Graft Occlusion, Vascular - physiopathology</topic><topic>Graft Occlusion, Vascular - prevention & control</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Original</topic><topic>Proportional Hazards Models</topic><topic>Prosthesis Design</topic><topic>Renal Dialysis</topic><topic>Retrospective Studies</topic><topic>Risk Assessment</topic><topic>Risk Factors</topic><topic>Taiwan</topic><topic>Time Factors</topic><topic>Treatment Outcome</topic><topic>Upper Extremity - blood supply</topic><topic>Vascular Patency</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hung, Yen-Ni</creatorcontrib><creatorcontrib>Ko, Po-Jen</creatorcontrib><creatorcontrib>Ng, Yee-Yung</creatorcontrib><creatorcontrib>Wu, Shiao-Chi</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><collection>PubMed Central (Full Participant titles)</collection><jtitle>Clinical journal of the American Society of Nephrology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hung, Yen-Ni</au><au>Ko, Po-Jen</au><au>Ng, Yee-Yung</au><au>Wu, Shiao-Chi</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The Longevity of Arteriovenous Graft for Hemodialysis Patients—Externally Supported or Nonsupported</atitle><jtitle>Clinical journal of the American Society of Nephrology</jtitle><addtitle>Clin J Am Soc Nephrol</addtitle><date>2010-06-01</date><risdate>2010</risdate><volume>5</volume><issue>6</issue><spage>1029</spage><epage>1035</epage><pages>1029-1035</pages><issn>1555-9041</issn><eissn>1555-905X</eissn><abstract>Because thrombosis and stenosis are the most frequent causes of arteriovenous graft (AVG) failure, several externally supported grafts were designed to enhance incompressibility and kinking resistance to improve the patency. However, consensus on advantage of these modifications having still not been reached might relate to the previous limited patient numbers and small studies. This study analyzed the longevity of externally supported and nonsupported AVG on the basis of the nationwide database to understand whether the externally supported design could improve the duration of patency of AVG.
Adult incident patients (n = 4402) were retrospectively enrolled who had began hemodialysis between January 1, 2002 and December 31, 2005. All incident patients with AVG, before or after beginning regular hemodialysis, between January 1, 2000 and December 31, 2006 were identified. The Cox proportional hazard model was used to compare the longevity of externally supported and nonsupported AVG by controlling other covariates.
There were 990 patients with externally supported AVG and 3412 patients with nonsupported AVG. The patency rates of externally supported AVG were 49.4%, 31.6%, and 20.2% at 1, 2 and 3 years, respectively; those of nonsupported AVG were 31.9%, 17.4%, and 10.8%. The survival of nonsupported AVG was significantly inferior to that of externally supported AVG.
Externally supported AVG are superior to nonsupported AVG for long-term patency. The incompressibility and kinking resistance of ringed grafts may shed light on a direction for the future development of dialysis graft design.</abstract><cop>United States</cop><pub>American Society of Nephrology</pub><pmid>20378642</pmid><doi>10.2215/CJN.08181109</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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subjects | Adolescent Adult Aged Arteriovenous Shunt, Surgical - adverse effects Arteriovenous Shunt, Surgical - instrumentation Blood Vessel Prosthesis Blood Vessel Prosthesis Implantation - adverse effects Blood Vessel Prosthesis Implantation - instrumentation Chi-Square Distribution Female Graft Occlusion, Vascular - etiology Graft Occlusion, Vascular - physiopathology Graft Occlusion, Vascular - prevention & control Humans Male Middle Aged Original Proportional Hazards Models Prosthesis Design Renal Dialysis Retrospective Studies Risk Assessment Risk Factors Taiwan Time Factors Treatment Outcome Upper Extremity - blood supply Vascular Patency Young Adult |
title | The Longevity of Arteriovenous Graft for Hemodialysis Patients—Externally Supported or Nonsupported |
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