Patient characteristics predict patency of early-cannulation arteriovenous grafts

Abstract There is a new emphasis on tailoring appropriate vascular access for hemodialysis to patients and their life-plans, but there is little known about the optimal use of newer devices such as early-cannulation arteriovenous grafts (ecAVG), with studies utilising them in a wide variety of situa...

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Autores principales:	David B. Kingsmore, Karen S. Stevenson, S. Richarz, Andrej Isaak, Andrew Jackson, Ram Kasthuri, Peter C. Thomson
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/573e0742f727423897c96a77318ec060
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spelling	oai:doaj.org-article:573e0742f727423897c96a77318ec0602021-12-02T14:49:25ZPatient characteristics predict patency of early-cannulation arteriovenous grafts10.1038/s41598-021-87750-62045-2322https://doaj.org/article/573e0742f727423897c96a77318ec0602021-05-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-87750-6https://doaj.org/toc/2045-2322Abstract There is a new emphasis on tailoring appropriate vascular access for hemodialysis to patients and their life-plans, but there is little known about the optimal use of newer devices such as early-cannulation arteriovenous grafts (ecAVG), with studies utilising them in a wide variety of situations. The aim of this study was to determine if the outcome of ecAVG can be predicted by patient characteristics known pre-operatively. This retrospective analysis of 278 consecutive ecAVG with minimum one-year follow-up correlated functional patency with demographic data, renal history, renal replacement and vascular access history. On univariate analysis, aetiology of renal disease, indication for an ecAVG, the number of previous tunnelled central venous catheters (TCVC) prior to insertion of an ecAVG, peripheral vascular disease, and BMI were significant associates with functional patency. On multivariate analysis the number of previous TCVC, the presence of peripheral vascular disease and indication were independently associated with outcome after allowing for age, sex and BMI. When selecting for vascular access, understanding the clinical circumstances such as indication and previous vascular access can identify patients with differing outcomes. Importantly, strategies that result in TCVC exposure have an independent and cumulative association with decreasing long-term patency for subsequent ecAVG. As such, TCVC exposure is best avoided or minimised particularly when ecAVG can be considered.David B. KingsmoreKaren S. StevensonS. RicharzAndrej IsaakAndrew JacksonRam KasthuriPeter C. ThomsonNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-10 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q David B. Kingsmore Karen S. Stevenson S. Richarz Andrej Isaak Andrew Jackson Ram Kasthuri Peter C. Thomson Patient characteristics predict patency of early-cannulation arteriovenous grafts
description	Abstract There is a new emphasis on tailoring appropriate vascular access for hemodialysis to patients and their life-plans, but there is little known about the optimal use of newer devices such as early-cannulation arteriovenous grafts (ecAVG), with studies utilising them in a wide variety of situations. The aim of this study was to determine if the outcome of ecAVG can be predicted by patient characteristics known pre-operatively. This retrospective analysis of 278 consecutive ecAVG with minimum one-year follow-up correlated functional patency with demographic data, renal history, renal replacement and vascular access history. On univariate analysis, aetiology of renal disease, indication for an ecAVG, the number of previous tunnelled central venous catheters (TCVC) prior to insertion of an ecAVG, peripheral vascular disease, and BMI were significant associates with functional patency. On multivariate analysis the number of previous TCVC, the presence of peripheral vascular disease and indication were independently associated with outcome after allowing for age, sex and BMI. When selecting for vascular access, understanding the clinical circumstances such as indication and previous vascular access can identify patients with differing outcomes. Importantly, strategies that result in TCVC exposure have an independent and cumulative association with decreasing long-term patency for subsequent ecAVG. As such, TCVC exposure is best avoided or minimised particularly when ecAVG can be considered.
format	article
author	David B. Kingsmore Karen S. Stevenson S. Richarz Andrej Isaak Andrew Jackson Ram Kasthuri Peter C. Thomson
author_facet	David B. Kingsmore Karen S. Stevenson S. Richarz Andrej Isaak Andrew Jackson Ram Kasthuri Peter C. Thomson
author_sort	David B. Kingsmore
title	Patient characteristics predict patency of early-cannulation arteriovenous grafts
title_short	Patient characteristics predict patency of early-cannulation arteriovenous grafts
title_full	Patient characteristics predict patency of early-cannulation arteriovenous grafts
title_fullStr	Patient characteristics predict patency of early-cannulation arteriovenous grafts
title_full_unstemmed	Patient characteristics predict patency of early-cannulation arteriovenous grafts
title_sort	patient characteristics predict patency of early-cannulation arteriovenous grafts
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/573e0742f727423897c96a77318ec060
work_keys_str_mv	AT davidbkingsmore patientcharacteristicspredictpatencyofearlycannulationarteriovenousgrafts AT karensstevenson patientcharacteristicspredictpatencyofearlycannulationarteriovenousgrafts AT sricharz patientcharacteristicspredictpatencyofearlycannulationarteriovenousgrafts AT andrejisaak patientcharacteristicspredictpatencyofearlycannulationarteriovenousgrafts AT andrewjackson patientcharacteristicspredictpatencyofearlycannulationarteriovenousgrafts AT ramkasthuri patientcharacteristicspredictpatencyofearlycannulationarteriovenousgrafts AT petercthomson patientcharacteristicspredictpatencyofearlycannulationarteriovenousgrafts
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Patient characteristics predict patency of early-cannulation arteriovenous grafts

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