Association of glomerular filtration rate slope with timely creation of vascular access in incident hemodialysis

Abstract The factors associated with the timely creation of distal vascular access for hemodialysis initiation are unclear. We aimed to explore the association between the slope of estimated glomerular filtration rate (eGFR) and the successful usage of vascular access upon hemodialysis initiation. T...

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Autores principales:	Lee-Moay Lim, Ming-Yen Lin, Shang-Jyh Hwang, Hung-Chun Chen, Yi-Wen Chiu
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/3734adcf99e94932a24ba02ed983b297
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spelling	oai:doaj.org-article:3734adcf99e94932a24ba02ed983b2972021-12-02T17:14:24ZAssociation of glomerular filtration rate slope with timely creation of vascular access in incident hemodialysis10.1038/s41598-021-92359-w2045-2322https://doaj.org/article/3734adcf99e94932a24ba02ed983b2972021-06-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-92359-whttps://doaj.org/toc/2045-2322Abstract The factors associated with the timely creation of distal vascular access for hemodialysis initiation are unclear. We aimed to explore the association between the slope of estimated glomerular filtration rate (eGFR) and the successful usage of vascular access upon hemodialysis initiation. This single center retrospective cohort study enrolled chronic kidney disease patients who undertook a multidisciplinary care program from 2003 to 2016. Using eGFR slope as predictor, we evaluated the vascular access created timely upon hemodialysis initiation. Among the 987 patients, vascular access was created at a median eGFR of 5.8 min/ml/1.73 m2, with a median duration of 3.1 months before hemodialysis. The proportions of vascular access created timely, created not timely (vascular access immature), and not created were 68.5%, 8.8%, and 22.7%, respectively. There was a significant negative association of eGFR upon vascular access creation with eGFR slope (r = − 0.182, P < 0.001). The fastest eGFR slope patients (the first quartile or < − 10 min/ml/1.73 m2/year) had the lowest percentage of vascular access created timely. In the multivariable logistic regression analysis, only higher eGFR upon vascular access creation (P = 0.001) and eGFR slope (P = 0.009) were significantly associated with vascular access created timely. The adjusted odds ratios of each quartile of eGFR slopes for vascular access created timely were 0.46 (95% confidence interval 0.27–0.86), 1.30 (0.62, 2.72), 1.00 (reference), and 0.95 (0.48–1.87), respectively. eGFR slope is associated with the timely creation of vascular access for the initiation of hemodialysis in a reverse-J-shaped pattern and may help determine the time of vascular access creation.Lee-Moay LimMing-Yen LinShang-Jyh HwangHung-Chun ChenYi-Wen ChiuNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-12 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Lee-Moay Lim Ming-Yen Lin Shang-Jyh Hwang Hung-Chun Chen Yi-Wen Chiu Association of glomerular filtration rate slope with timely creation of vascular access in incident hemodialysis
description	Abstract The factors associated with the timely creation of distal vascular access for hemodialysis initiation are unclear. We aimed to explore the association between the slope of estimated glomerular filtration rate (eGFR) and the successful usage of vascular access upon hemodialysis initiation. This single center retrospective cohort study enrolled chronic kidney disease patients who undertook a multidisciplinary care program from 2003 to 2016. Using eGFR slope as predictor, we evaluated the vascular access created timely upon hemodialysis initiation. Among the 987 patients, vascular access was created at a median eGFR of 5.8 min/ml/1.73 m2, with a median duration of 3.1 months before hemodialysis. The proportions of vascular access created timely, created not timely (vascular access immature), and not created were 68.5%, 8.8%, and 22.7%, respectively. There was a significant negative association of eGFR upon vascular access creation with eGFR slope (r = − 0.182, P < 0.001). The fastest eGFR slope patients (the first quartile or < − 10 min/ml/1.73 m2/year) had the lowest percentage of vascular access created timely. In the multivariable logistic regression analysis, only higher eGFR upon vascular access creation (P = 0.001) and eGFR slope (P = 0.009) were significantly associated with vascular access created timely. The adjusted odds ratios of each quartile of eGFR slopes for vascular access created timely were 0.46 (95% confidence interval 0.27–0.86), 1.30 (0.62, 2.72), 1.00 (reference), and 0.95 (0.48–1.87), respectively. eGFR slope is associated with the timely creation of vascular access for the initiation of hemodialysis in a reverse-J-shaped pattern and may help determine the time of vascular access creation.
format	article
author	Lee-Moay Lim Ming-Yen Lin Shang-Jyh Hwang Hung-Chun Chen Yi-Wen Chiu
author_facet	Lee-Moay Lim Ming-Yen Lin Shang-Jyh Hwang Hung-Chun Chen Yi-Wen Chiu
author_sort	Lee-Moay Lim
title	Association of glomerular filtration rate slope with timely creation of vascular access in incident hemodialysis
title_short	Association of glomerular filtration rate slope with timely creation of vascular access in incident hemodialysis
title_full	Association of glomerular filtration rate slope with timely creation of vascular access in incident hemodialysis
title_fullStr	Association of glomerular filtration rate slope with timely creation of vascular access in incident hemodialysis
title_full_unstemmed	Association of glomerular filtration rate slope with timely creation of vascular access in incident hemodialysis
title_sort	association of glomerular filtration rate slope with timely creation of vascular access in incident hemodialysis
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/3734adcf99e94932a24ba02ed983b297
work_keys_str_mv	AT leemoaylim associationofglomerularfiltrationrateslopewithtimelycreationofvascularaccessinincidenthemodialysis AT mingyenlin associationofglomerularfiltrationrateslopewithtimelycreationofvascularaccessinincidenthemodialysis AT shangjyhhwang associationofglomerularfiltrationrateslopewithtimelycreationofvascularaccessinincidenthemodialysis AT hungchunchen associationofglomerularfiltrationrateslopewithtimelycreationofvascularaccessinincidenthemodialysis AT yiwenchiu associationofglomerularfiltrationrateslopewithtimelycreationofvascularaccessinincidenthemodialysis
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Association of glomerular filtration rate slope with timely creation of vascular access in incident hemodialysis

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