Document Detail


Long-term Outcomes of Arteriovenous Thigh Grafts in Hemodialysis Patients: A Comparison with Tunneled Dialysis Catheters.
MedLine Citation:
PMID:  23371958     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND AND OBJECTIVE: Arteriovenous thigh grafts are a potential vascular access option in hemodialysis patients who have exhausted all upper-limb sites. This study compared the outcomes of thigh grafts with outcomes obtained with dialysis catheters. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: A prospective vascular access database was queried to identify 209 thigh grafts placed from January 1, 2003, to June 30, 2011. The following were calculated: secondary graft survival (from graft creation to permanent failure), assisted primary graft survival (from graft creation to first thrombosis), and infection-free graft survival (from graft creation to first graft infection). Graft outcomes were compared with those observed with 472 tunneled internal jugular dialysis catheters. RESULTS: The median duration of patient follow-up was 340 days for grafts and 91 days for catheters. The surgical technical failure rate of thigh grafts was 8.1% and was higher in patients with vascular disease (hazard ratio [HR], 2.94; 95% confidence interval [CI], 1.07-8.04; P=0.03). Secondary and assisted primary graft survival rates at 1, 2, and 5 years were 62%, 54%, and 38% and 38%, 27%, and 17%, respectively. Infection-free graft survival rates at 1, 2, and 5 years were 79%, 73%, and 61%. Secondary survival was much worse for dialysis catheters than thigh grafts (HR, 4.44; 95% CI, 3.65-5.22; P<0.001). Likewise, infection-free survival was far worse for catheters than for thigh grafts (HR, 3.77; 95% CI, 2.80-4.82; P<0.001). CONCLUSIONS: Thigh grafts are a viable vascular option in patients who have exhausted upper-extremity options. Outcomes with thigh grafts are superior to those obtained with dialysis catheters.
Authors:
Song Ong; Jill Barker-Finkel; Michael Allon
Related Documents :
22964668 - Factors associated with failed hardware salvage in high-risk patients after microsurgic...
23210118 - Resistant itchy lesions in a young man.
24559748 - The relationship between perimesencephalic subarachnoid hemorrhage and deep venous syst...
19846848 - Intensity of continuous renal-replacement therapy in critically ill patients.
11214698 - Spinal cord stimulation in patients with refractory anginal pain and normal coronary ar...
15209838 - Length of therapy with selective serotonin reuptake inhibitors and tricyclic antidepres...
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-1-31
Journal Detail:
Title:  Clinical journal of the American Society of Nephrology : CJASN     Volume:  -     ISSN:  1555-905X     ISO Abbreviation:  Clin J Am Soc Nephrol     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-2-1     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101271570     Medline TA:  Clin J Am Soc Nephrol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Division of Nephrology, University of Alabama at Birmingham, Birmingham, Alabama, and, †Department of Microbiology, Montana State University, Bozeman, Montana.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Dialysate Calcium Concentration and the Risk of Sudden Cardiac Arrest in Hemodialysis Patients.
Next Document:  Precision of Estimating Equations for GFR in Children with a Solitary Functioning Kidney: The KIMONO...