Tunnelled haemodialysis catheter and haemodialysis outcomes: a retrospective cohort study in Zagreb, Croatia

Pašara, Vedran and Maksimović, Bojana and Gunjača, Mihaela and Mihovilović, Karlo and Lončar, Andrea and Kudumija, Boris and Žabić, Igor and Knotek, Mladen (2016) Tunnelled haemodialysis catheter and haemodialysis outcomes: a retrospective cohort study in Zagreb, Croatia. BMJ Open, 6. e009757. ISSN 2044-6055

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Abstract

OBJECTIVES: Studies have reported that the tunnelled dialysis catheter (TDC) is associated with inferior haemodialysis (HD) patient survival, in comparison with arteriovenous fistula (AVF). Since many cofactors may also affect survival of HD patients, it is unclear whether the greater risk for survival arises from TDC per se, or from associated conditions. Therefore, the aim of this study was to determine, in a multivariate analysis, the long-term outcome of HD patients, with respect to vascular access (VA). ----- DESIGN: Retrospective cohort study. ----- PARTICIPANTS: This retrospective cohort study included all 156 patients with a TDC admitted at University Hospital Merkur, from 2010 to 2012. The control group consisted of 97 patients dialysed via AVF. The groups were matched according to dialysis unit and time of VA placement. The site of choice for the placement of the TDC was the right jugular vein. Kaplan-Meier analysis with log-rank test was used to assess patient survival. Multivariate Cox regression analysis was used to determine independent variables associated with patient survival. ----- PRIMARY OUTCOME MEASURES: Patient survival with respect to VA. ----- RESULTS: The cumulative 1-year survival of patients who were dialysed exclusively via TDC was 86.4% and of those who were dialysed exclusively via AVF, survival was 97.1% (p=0.002). In multivariate Cox regression analysis, male sex and older age were independently negatively associated with the survival of HD patients, while shorter HD vintage before the creation of the observed VA, hypertensive renal disease and glomerulonephritis were positively associated with survival. TDC was an independent risk factor for survival of HD patients (HR 23.0, 95% CI 6.2 to 85.3). ----- CONCLUSION: TDC may be an independent negative risk factor for HD patient survival.

Item Type: Article
Additional Information: This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work noncommercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http:// creativecommons.org/licenses/by-nc/4.0/
MeSH: Arteriovenous Shunt, Surgical / mortality ; Catheterization, Central Venous / adverse effects ; Catheters, Indwelling / adverse effects ; Croatia / epidemiology ; Female ; Humans ; Jugular Veins ; Kaplan-Meier Estimate ; Kidney Failure, Chronic / mortality ; Kidney Failure, Chronic / physiopathology ; Kidney Failure, Chronic / therapy ; Male ; Middle Aged ; Renal Dialysis / methods ; Renal Dialysis / mortality ; Retrospective Studies ; Survival Analysis
Departments: Katedra za internu medicinu
Depositing User: Martina Žužak
Status: Published
Creators:
CreatorsEmail
Pašara, VedranUNSPECIFIED
Maksimović, BojanaUNSPECIFIED
Gunjača, MihaelaUNSPECIFIED
Mihovilović, KarloUNSPECIFIED
Lončar, AndreaUNSPECIFIED
Kudumija, BorisUNSPECIFIED
Žabić, IgorUNSPECIFIED
Knotek, MladenUNSPECIFIED
Date: 17 May 2016
Date Deposited: 11 Oct 2017 07:26
Last Modified: 12 Aug 2020 11:57
Subjects: UNSPECIFIED
Related URLs:
URI: http://medlib.mef.hr/id/eprint/2696

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