Abstract: SA-PO0454
COVID-19 Disease (C19D), Vaccination (C19V), and Vascular Access Complications Among Patients on Hemodialysis
Session Information
- Dialysis: Vascular Access
November 08, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 803 Dialysis: Vascular Access
Authors
- Owen, Jonathan G., The University of New Mexico Department of Internal Medicine, Albuquerque, New Mexico, United States
- Schmidt, Darren W., The University of New Mexico Department of Internal Medicine, Albuquerque, New Mexico, United States
- Mir, Hamza, The University of New Mexico Department of Internal Medicine, Albuquerque, New Mexico, United States
- Roumelioti, Maria-Eleni, The University of New Mexico Department of Internal Medicine, Albuquerque, New Mexico, United States
- Argyropoulos, Christos, University of New Mexico Clinical and Translational Science Center, Albuquerque, New Mexico, United States
Background
C19D has been identified as a contributor to thrombotic complications, but it is unclear whether these complications extend to vascular access . Concerns about similar complications by the C19V may also contribute to vaccine hesitancy among hemodialysis (HD) patients. We explored the association of both C19D and C19V with vascular access thrombotic events.
Methods
We included all patients who had a positive (+ve) C19 test and a HD access intervention[MR1] (CPT codes 36901, 36902, 36903, 36904, 36905, 36906) between 3/1/20-3/31/24 in any US institute in the TrinetX database. C19V, and C19D were assessed by +ve results in respiratory panel testing (RPT) and the vaccination records in TrinetX. We used a Self-Controlled Case Series (SCSS, BMJ 2016;354:i4515) to analyze the relative risk (RR) of repeat C19D and C19V on access interventions.
Results
We identified 15,877 patients with an average of 2.17 ± 2 interventions, 0.46 ± 0.96 episodes of C19 detected via an average of 3.71 ± 3 RPT tests. 43.9% of the patients were female, 61.2 ± 14 years old, 37.6% were African American, 13.2% were Hispanic; 22% patients died during the observation period. C19V was not associated with an increased RR of vascular access interventions at any post-vaccination time point (Table). However,, C19D was associated with an increased RR after the first month (RR: 1.5 - 1.8) with the risk persisting for at least 4 months post-infection.
Conclusion
C19D (but not C19V) is temporally associated with a higher rate of vascular access interventions. This information should be communicated to patients who may opt out of C19V for fear of complications. Prospective observation of patients post-C19D for early signs of access dysfunction (which may be a HD related form of "Long Covid") should be considered.
Time Dependent RR (95% CI and p-values) of vascular access intervention relative to C19D and C19V
| Time Period | Vaccination | Covid19 Episode |
| 0-30 days | 0.15 (0.14-0.16) p < 0.001 | 0.16 (0.15-0.18) p < 0.001 |
| 31-60 days | 0.89 (0.79-0.99) p = 0.028 | 1.54 (1.38-1.73) p < 0.001 |
| 61-90 days | 0.93 (0.83-1.03) p = 0.170 | 1.82 (1.61-2.04) p < 0.001 |
| 91-120 days | 0.82 (0.73-0.92) p = 0.001 | 1.70 (1.50-1.92) p < 0.001 |
| 121+ days | 0.58 (0.56-0.61) p < 0.001 | 1.59 (1.53-1.66) p < 0.001 |
Funding
- Other NIH Support