1. Access flow volume (Qa) and survival in a haemodialysis population
- Author
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Maarten G. J. Snoeijs, Reshabh Yadav, Michael W.M. Gerrickens, Roel H.D. Vaes, Marc R. Scheltinga, Sander M. J. van Kuijk, MUMC+: KIO Kemta (9), RS: CAPHRI - R2 - Creating Value-Based Health Care, Vascular Surgery, MUMC+: MA Med Staf Spec Vaatchirurgie (9), and RS: Carim - V03 Regenerative and reconstructive medicine vascular disease
- Subjects
Male ,Dilution technique ,medicine.medical_treatment ,Population ,survival ,STENOSIS ,DISEASE ,End stage renal disease ,Arteriovenous Shunt, Surgical ,Renal Dialysis ,VASCULAR ACCESS ,Medicine ,Humans ,In patient ,CARDIAC-OUTPUT ,education ,Cardiovascular mortality ,Aged ,Proportional Hazards Models ,Aged, 80 and over ,RISK ,Transplantation ,education.field_of_study ,PERCUTANEOUS TRANSLUMINAL ANGIOPLASTY ,end-stage renal disease ,Receiver operating characteristic ,business.industry ,ARTERIOVENOUS-FISTULA ,MORTALITY ,Middle Aged ,access flow ,haemodialysis ,CREATION ,ROC Curve ,Nephrology ,Regional Blood Flow ,HEART ,Hemodialysis ,business ,Nuclear medicine - Abstract
Background The aim of this study was to determine associations between characteristics of arteriovenous access (AVA) flow volume (Qa; mL/min) and 4-year freedom from cardiovascular mortality (CVM) in haemodialysis (HD) patients. Methods HD patients who received a primary AVA between January 2010 and December 2017 in one centre were analysed. Initial Qa was defined as the first Qa value obtained in a well-functioning AVA by a two-needle dilution technique. Actual Qa was defined as access flow at a random point in time. Changes in actual Qa were expressed per 3-month period. CVM was assessed according to the European Renal Association–European Dialysis and Transplant Association classification. The optimal cut-off point for initial Qa was identified by a receiver operating characteristics curve. A joint modelling statistical technique determined longitudinal associations between Qa characteristics and 4-year CVM. Results A total of 5208 Qa measurements (165 patients; 103 male, age 70 ± 12 years, autologous AVA n = 146, graft n = 19) were analysed. During follow-up (December 2010–January 2018, median 36 months), 79 patients (48%) died. An initial Qa Conclusions Studying novel AVA Qa characteristics may contribute to understanding excess CVM in HD patients.
- Published
- 2022