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Kidney Week

Abstract: PO1336

Evaluation of Stable Permanent Hemodialysis Access Bleeding Time After Dialysis Needle Removal

Session Information

  • Vascular Access
    October 22, 2020 | Location: On-Demand
    Abstract Time: 10:00 AM - 12:00 PM

Category: Dialysis

  • 704 Dialysis: Vascular Access

Authors

  • Yalamanchili, Samshita, Albany Medical College, Albany, New York, United States
  • Der Mesropian, Paul J., Albany Stratton VA Medical Center, Albany, New York, United States
  • Shaikh, Gulvahid G., Albany Stratton VA Medical Center, Albany, New York, United States
  • Salman, Loay H., Albany Medical College, Albany, New York, United States
  • Gosmanova, Elvira O., Albany Stratton VA Medical Center, Albany, New York, United States
Background

Prolonged bleeding time (BT) after dialysis needle removal may signify permanent hemodialysis access (PHA) dysfunction but “normal” BT is not well defined.

Methods

This was an observational study examining 35 patients receiving chronic hemodialysis with PHA using 15-g needles for ≥3m at Stratton VAMC, Albany NY. BT was determined as no bleeding at dialysis needle removal site after manual pressure applied for at least 10min with additional 1-5 minutes increments, if needed. The mean BT for arterial and venous sites were calculated for each patient over 1-month period. Associations between BT and baseline characteristics were evaluated using adjusted regression analysis.

Results

The mean age of patients was 73 yrs, 97% were males, 63 and 31% were Whites and Blacks, respectively. The mean (SD) hemoglobin concentration and platelet count were 10.4 (1.0)g/dL and 184 (77)x109/L, respectively. Sixty and 74% of patients were on oral antiplatelet agents and intradialytic heparin. The mean (SD) BT after arterial and venous needle removal were 12.7 (2.1) and 12.9 (2.2) minutes. In the adjusted analyses, there was strong correlation between arterial and venous BT (r2=0.98, p<0.016), however, no correlations were seen between arterial and venous BT and any baseline variables (Table).

Conclusion

In this study, BT after dialysis needle removal was between 10 and 15 min in patients with stable PHA. Future studies are needed to understand what changes in BT may predict PHA dysfunction.

VariableArterial Needle SiteVenous Needle Site
Correlation CoefficientP-valueCorrelation CoefficientP-value
Age0.170.40.180.4
Gender-0.070.7-0.060.8
Ethnicity-0.090.7-0.030.9
BMI0.110.60.130.6
Permanent Dialysis Access-0.040.8-0.050.8
Previous Access Complications0.240.30.260.2
Diabetes-0.010.9-0.020.9
Hypertension-0.050.8-0.040.9
Heparin Use-0.130.6-0.140.5
Heparin Dose-0.220.3-0.280.2
Antiplatelet Use-0.240.3-0.230.3
Hemoglobin Concentration0.270.30.210.3
Platelet Count-0.330.1-0.290.2