Document Detail


Vascular access and increased risk of death among hemodialysis patients.
MedLine Citation:
PMID:  12110026     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Hemodialysis with a venous catheter increases the risk of infection. The extent to which venous catheters are associated with an increased risk of death among hemodialysis patients has not been extensively studied. METHODS: We conducted a retrospective cohort study of 7497 prevalent hemodialysis patients to assess the association between dialysis with a venous catheter and risk of death due to all causes and to infection. RESULTS: A tunneled cuffed catheter was used for access in 12% of the patients and non-cuffed, not tunneled catheter in 2%. Younger age (P = 0.0005), black race (P = 0.0022), female gender (P = 0.0004), short duration since starting dialysis (P = 0.0003) and impaired functional status (P = 0.0001) were independently associated with increased use of catheter access. The proportion of patients who died was higher among those who were dialyzed with a non-cuffed (16.8%) or cuffed (15.2%) catheter compared to those dialyzed with either a graft (9.1%) or a fistula (7.3%; P < 0.001). The proportion of deaths due to infection was higher among patients dialyzed with a catheter (3.4%) compared to those dialyzed with either a graft (1.2%) or a fistula (0.8%; P < 0.001). The adjusted odds ratio (95% CI) for all-cause and infection-related death among patients dialyzed with a catheter was 1.4 (1.1, 1.9) and 3.0 (1.4, 6.6), respectively, compared to those with an arteriovenous (AV) fistula. CONCLUSION: Venous catheters are associated with an increased risk of all-cause and infection-related mortality among hemodialysis patients.
Authors:
Stephen Pastan; J Michael Soucie; William M McClellan
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Kidney international     Volume:  62     ISSN:  0085-2538     ISO Abbreviation:  Kidney Int.     Publication Date:  2002 Aug 
Date Detail:
Created Date:  2002-07-11     Completed Date:  2003-01-13     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0323470     Medline TA:  Kidney Int     Country:  United States    
Other Details:
Languages:  eng     Pagination:  620-6     Citation Subset:  IM    
Affiliation:
Renal Division, Department of Medicine, Rollins School of Public Health, Emory University, Atlanta, Georgia 30322, USA.
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MeSH Terms
Descriptor/Qualifier:
Aged
Arteriovenous Shunt, Surgical / mortality
Catheterization, Peripheral / mortality*
Cohort Studies
Female
Follow-Up Studies
Humans
Kidney Failure, Chronic / mortality*,  therapy
Male
Middle Aged
Renal Dialysis / mortality*
Retrospective Studies
Risk Factors
Comments/Corrections
Comment In:
Kidney Int. 2003 Feb;63(2):767-8   [PMID:  12631148 ]

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


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