Kidney Week

Abstract: FR-PO780

Association between Post-Dialysis Hemoglobin Level and the Survival of Vascular Access

Session Information

• Hemodialysis: Vascular Access - II
  November 03, 2017 | Location: Hall H, Morial Convention Center
  Abstract Time: 10:00 AM - 10:00 AM

Category: Dialysis

• 603 Hemodialysis: Vascular Access

Authors

• Nishiwaki, Hiroki, Showa University Fujigaoka Hospital, Yokohama, Japan

Hiroki Nishiwaki,

• Hasegawa, Takeshi, Showa University Fujigaoka Hospital, Yokohama, Japan

Takeshi Hasegawa,

• Tominaga, Naoto, Georgetown University Medical Center, Washington, District of Columbia, United States

Naoto Tominaga,

• Yazawa, Masahiko, Division of Nephrology and Hypertension, Department of Internal Medicine, St.Marianna University School of Medicine, Kawasaki, Japan

Masahiko Yazawa,

• Kawarazaki, Hiroo, None, Tokyo, Japan

Hiroo Kawarazaki,

• Ikenoue, Tatsuyoshi, Kyoto University Graduate School of Medicine and Public Health, Kyoto, KYOTO, Japan

Tatsuyoshi Ikenoue,

• Shibagaki, Yugo, Division of Nephrology and Hypertension, St Marianna University Hospital, Kawasaki, Japan

Yugo Shibagaki,

• Fukuma, Shingo, Kyoto University , Kyoto, Japan

Shingo Fukuma,

• Fukuhara, Shunichi, Kyoto University , Kyoto, Japan

Shunichi Fukuhara,

Background

Although a few dialysis facilities conduct a complete blood cell count for some patients at post-dialysis, including hemoglobin, clinical findings supporting the interpretation of results are scarce. The aim of this study was to investigate the association between post-dialysis hemoglobin level and vascular access failure with clinical data.

Methods

Study Design: Case crossover design
Setting: Japanese dialysis facilities which routinely take post-dialysis blood samples, including complete blood cell counts at least once a month.
Participants: Hemodialysis patients who experienced vascular access failure in Jan. 2010- Dec. 2014.
Exposure: Post-dialysis hemoglobin level
Main outcome: Vascular access failure treated with endovascular treatment or operation.
Statistical analysis: Self-matched odds ratios and 95% confidence intervals were estimated by comparing post-dialysis hemoglobin just before events (“case”) with levels at 6 and 12 months before events (“control”) using conditional logistic regression, and presented with restricted cubic spline.

Results

230 hemodialysis patients with vascular access failure were identified. Mean post-dialysis hemoglobin level before the failure was 11.8 g/dl (standard deviation 1.7). The spline curve showed that higher post-dialysis hemoglobin levels above 11.8 g/dl had a greater odds ratio for vascular access failure. Post-dialysis hemoglobin levels and odds ratios (95% Confidence Interval) for vascular access failure relative to the reference value (Hb 11.8 g/dl) were Hb 12.0 g/dl, 1.1 (1.0-1.1); Hb 14.0 g/dl, 3.3 (1.3-8.3); and Hb 16.0 g/dl, 12.7 (1.8-89.4).

Conclusion

A higher post-dialysis hemoglobin level was associated with vascular access failure. Higher post-dialysis Hb could be a factor which triggers vascular access failure.

Funding

• Private Foundation Support