Abstract: SA-PO1103
Timely Creation of Peripheral Vascular Access for Planned Initiation of Hemodialysis
Session Information
- Vascular Access - II
November 09, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 704 Dialysis: Vascular Access
Authors
- Chiu, Yi-Wen, Kaohsiung Medical University, Kaohsiung, Taiwan
- Lim, Lee-Moay, Kaohsiung Medical University Hospital, Kaohsiung City, Taiwan
- Lin, Ming-Yen, Kaohsiung Medical University, Kaohsiung, Taiwan
- Hwang, Shang-Jyh, Kaohsiung Medical University Hospital, Kaohsiung City, Taiwan
Background
Factor associated with timely creation of peripheral vascular access (VA) for planned initiation of hemodialysis is not clear.
Methods
From 2003 through 2016, every patient enrolled in integrated CKD program for more than 6 months and closed with the status of HD were included. The eGFR slope was counted between CKD program enrollment and VA creation or starting HD, which came first. We defined VA created timely as using VA when starting HD.
Results
Total 998 ESKD patients were included. (Age 65±12 y/o, Male 53%, DM 50%) The portion of VA created timely, created not timely and not created were 69%, 9% and 22%, respectively. By calendar year, created timely had the percentage increasing and around 74% in the last 6 years. Compared with not created, VA created timely had shallower eGFR slope (-4.2(-7.4, -2.3) vs -5.6(-10.8, -3.1), ml/min/1.73m2/yr; p<0.0001), lower eGFR on first HD (4.3(3.4, 5.4) vs 4.6(3.4, 6.0), ml/min/1.73m2; p=0.011) and longer stay at CKD program (729(417, 1439) vs 504(309, 1077), days; p<0.0001). There was a negative association of eGFR at VA creation with eGFR slope among VA created before HD (figure 1, r=-0.182, p<0.0001). Compared with created not timely, VA created timely had longer duration after VA creation till HD (108(53, 237) vs 14(7, 28); p<0.0001), shallower eGFR slope (-4.2(-7.4, -2.3) vs -4.8(-9.7, -2.2); p<0.0001), higher eGFR at VA creation (5.9(4.8, 7.2) vs 5.1(3.8, 7.1); p<0.005) and longer stay at CKD program (729(417, 1439) vs 521(312, 1048); p<0.0001). In multivariable analysis, only higher eGFR at VA creation (p=0.004) and shallower eGFR slope (p=0.05) were significant with timely creation of VA.
Conclusion
We disclosure that the stay in CKD program and eGFR slope are associated with timely creation of peripheral VA for HD initiation, and may be helpful with determining the time of peripheral VA creation.