Abstract: TH-PO0966
Does Vascular Access Influence Dialysis Quality Outcomes? A Retrospective Cohort Study of Incident Hemodialysis Patients
Session Information
- Vascular Access: Research and Cases
October 22, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 803 Dialysis: Vascular Access
Authors
- Khan, Sobia, Stony Brook University, Stony Brook, New York, United States
- Bano, Ruqiyya, Stony Brook University, Stony Brook, New York, United States
Background
Dialysis key quality metrics; dialysis adequacy (Kt/V), hemoglobin targets, and hospitalization rates are widely used to evaluate end-stage kidney disease (ESKD) patient outcome. However, the extent to which vascular access type affects achievement of these quality benchmarks and related clinical outcomes remains unclear.
Methods
We conducted a retrospective cohort study of 104 incident hemodialysis patients. Patients grouped according to vascular access type: central venous catheter (CVC), arteriovenous fistula (AVF), and transition from CVC to AVF (CVC ->AVF). Baseline demographics and comorbidities were compared.
Outcomes included hospitalization within 1 year of ESKD diagnosis, emergency department visits, mortality, mean hemoglobin, hemoglobin target attainment, dialysis adequacy (spKt/V), and spKt/V target attainment. Continuous variables analyzed using ANOVA for parametric variables and Wilcoxon Rank-Sum Test for non-parametric variables while categorical variables compared using χ2-test or Fisher's exact test as appropriate.
Results
Among 104 patients, 17 (16%) had CVC, 44 (42%) AVF and 43 (41%) CVC --> AVF. Baseline demographic characteristics and comorbid conditions were similar among groups.
CVC Patients had significantly lower mean hemoglobin levels during follow-up compared with AVF and CVC->AVF groups (9.7±1.4 vs 10.4±1.1 vs 10.8±0.8 g/dL, p=0.008). Hemoglobin target attainment also varied significantly by access type and was lowest in CVC group (41% vs 57% vs 77%, p=0.010).
There was also a clinically meaningful trend toward higher hospitalization rates among patients with CVC access vs AVF and CVC->AVF groups (71% vs 39% vs 56%, p=0.056). Median hospitalization burden, ED visits, mortality, mean spKt/V, and spKt/V target attainment were not significantly different across groups.
Conclusion
Catheter dependent hemodialysis patients were more likely to have poorer anemia-related quality metrics and greater acute care utilization despite similar dialysis adequacy measures. CVC-> AVF patients achieved highest hemoglobin target attainment, suggesting potential clinical benefit from successful vascular access transition. These findings highlight vascular access, an important factor influencing hemodialysis quality outcomes. Our study identified CVC patients as a vulnerable subgroup that may benefit from targeted interventions and quality improvement strategies.