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Stable incidence and survival of arteriovenous fistulas over 39 years: A long-term national cohort study

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@article{079ed2a8b27d44b0ac5fe9da3e84f654,
title = "Stable incidence and survival of arteriovenous fistulas over 39 years: A long-term national cohort study",
abstract = "INTRODUCTION: The age and number of comorbidities in the hemodialysis population has increased over time. This may influence the construction and survival of the arteriovenous fistula (AVF). The present study explored the incidence and survival of AVFs over a period of 39 years.METHODS: A retrospective cohort study was conducted based on Danish registries. Incident hemodialysis patients between 1977 and 2015 were included. The incidence of AVF and factors associated with the construction of an AVF were described. Risk factors for AVF survival and repair were explored by Kaplan Meier and Cox proportional hazard analysis.RESULTS: The total number of arteriovenous accesses (AVF and arteriovenous grafts) were 10,187 and there were 4201 central venous catheters (CVC). No significant difference in the proportion of AVFs during the 39 years was seen. Age and renal diagnosis did not influence the proportion of AVFs. Patients with CVCs were found to have a significantly higher prevalence of comorbidities (p < 0.01). AVF survival remained stable during the 39 years. The first constructed AVF had the best survival, 35% still functioning after 15 years. Factors such as brachiocephalic AVF, female sex, and diabetic nephropathy increased the risk of AVF failure (Odds Ratio (OR): 2.46, 95% Confidence Interval (CI) (2.29-2.65), 1.17 (1.10-1.25), and 1.21 (1.12-1.3)), respectively.CONCLUSION: Despite an older dialysis population, the proportion and survival of the AVF in the Danish dialysis population has not changed, probably because of increased awareness of AVF as the first choice of vascular access and improved surveillance, surgery, and repair.",
keywords = "Hemodialysis, AV access, arteriovenous fistula, failure, incidence",
author = "Kristine Lindhard and Ditte Hansen and {Lindegaard Pedersen}, Brian and Marianne Rix and Hansen, {Henrik Post} and Jensen, {Boye L} and James Heaf",
year = "2021",
month = sep,
day = "14",
doi = "10.1177/11297298211046102",
language = "English",
journal = "Journal of Vascular Access",
issn = "1129-7298",
publisher = "Wichtig Editore s.r.l",

}

RIS

TY - JOUR

T1 - Stable incidence and survival of arteriovenous fistulas over 39 years

T2 - A long-term national cohort study

AU - Lindhard, Kristine

AU - Hansen, Ditte

AU - Lindegaard Pedersen, Brian

AU - Rix, Marianne

AU - Hansen, Henrik Post

AU - Jensen, Boye L

AU - Heaf, James

PY - 2021/9/14

Y1 - 2021/9/14

N2 - INTRODUCTION: The age and number of comorbidities in the hemodialysis population has increased over time. This may influence the construction and survival of the arteriovenous fistula (AVF). The present study explored the incidence and survival of AVFs over a period of 39 years.METHODS: A retrospective cohort study was conducted based on Danish registries. Incident hemodialysis patients between 1977 and 2015 were included. The incidence of AVF and factors associated with the construction of an AVF were described. Risk factors for AVF survival and repair were explored by Kaplan Meier and Cox proportional hazard analysis.RESULTS: The total number of arteriovenous accesses (AVF and arteriovenous grafts) were 10,187 and there were 4201 central venous catheters (CVC). No significant difference in the proportion of AVFs during the 39 years was seen. Age and renal diagnosis did not influence the proportion of AVFs. Patients with CVCs were found to have a significantly higher prevalence of comorbidities (p < 0.01). AVF survival remained stable during the 39 years. The first constructed AVF had the best survival, 35% still functioning after 15 years. Factors such as brachiocephalic AVF, female sex, and diabetic nephropathy increased the risk of AVF failure (Odds Ratio (OR): 2.46, 95% Confidence Interval (CI) (2.29-2.65), 1.17 (1.10-1.25), and 1.21 (1.12-1.3)), respectively.CONCLUSION: Despite an older dialysis population, the proportion and survival of the AVF in the Danish dialysis population has not changed, probably because of increased awareness of AVF as the first choice of vascular access and improved surveillance, surgery, and repair.

AB - INTRODUCTION: The age and number of comorbidities in the hemodialysis population has increased over time. This may influence the construction and survival of the arteriovenous fistula (AVF). The present study explored the incidence and survival of AVFs over a period of 39 years.METHODS: A retrospective cohort study was conducted based on Danish registries. Incident hemodialysis patients between 1977 and 2015 were included. The incidence of AVF and factors associated with the construction of an AVF were described. Risk factors for AVF survival and repair were explored by Kaplan Meier and Cox proportional hazard analysis.RESULTS: The total number of arteriovenous accesses (AVF and arteriovenous grafts) were 10,187 and there were 4201 central venous catheters (CVC). No significant difference in the proportion of AVFs during the 39 years was seen. Age and renal diagnosis did not influence the proportion of AVFs. Patients with CVCs were found to have a significantly higher prevalence of comorbidities (p < 0.01). AVF survival remained stable during the 39 years. The first constructed AVF had the best survival, 35% still functioning after 15 years. Factors such as brachiocephalic AVF, female sex, and diabetic nephropathy increased the risk of AVF failure (Odds Ratio (OR): 2.46, 95% Confidence Interval (CI) (2.29-2.65), 1.17 (1.10-1.25), and 1.21 (1.12-1.3)), respectively.CONCLUSION: Despite an older dialysis population, the proportion and survival of the AVF in the Danish dialysis population has not changed, probably because of increased awareness of AVF as the first choice of vascular access and improved surveillance, surgery, and repair.

KW - Hemodialysis

KW - AV access

KW - arteriovenous fistula

KW - failure

KW - incidence

UR - http://www.scopus.com/inward/record.url?scp=85115006503&partnerID=8YFLogxK

U2 - 10.1177/11297298211046102

DO - 10.1177/11297298211046102

M3 - Journal article

C2 - 34521278

JO - Journal of Vascular Access

JF - Journal of Vascular Access

SN - 1129-7298

ER -

ID: 67623218