Predictors of time to first cannulation for arteriovenous fistula in pediatric hemodialysis patients: Midwest Pediatric Nephrology Consortium study
Background Permanent vascular access (PVA) is preferred for long-term hemodialysis. Arteriovenous fistulae (AVF) have the best patency and the lowest complication rates compared to arteriovenous grafts (AVG) and tunneled cuffed catheters (TCC). However, AVF need time to mature. This study aimed to investigate predictors of time to first cannulation for AVF in pediatric hemodialysis patients. Methods Data on first AVF and AVG of patients at 20 pediatric dialysis centers were collected retrospectively, including demographics, clinical information, dialysis markers, and surgical data. Statistical modeling was used to investigate predictors of outcome. Results First PVA was created in 117 children: 103 (88%) AVF and 14 (12%) AVG. Mean age at AVF creation was 15.0 ± 3.3 years. AVF successfully matured in 89 children (86.4%), and mean time to first cannulation was 3.6 ± 2.5 months. In a multivariable regression model, study center, age, duration of non-permanent vascular access (NPVA), and Kt/V at AVF creation predicted time to first cannulation, with study center as the strongest predictor (p < 0.01). Time to first cannulation decreased with increasing age (p = 0.03) and with increasing Kt/V (p = 0.01), and increased with duration of NPVA (p = 0.03). Secondary failure occurred in 10 AVF (11.8%). Time to first cannulation did not predict secondary failure (p = 0.29), but longer time to first cannulation tended towards longer secondary patency (p = 0.06). Conclusions Study center is the strongest predictor of time to first cannulation for AVF and deserves further investigation. Time to first cannulation is significantly shorter in older children, with more efficient dialysis treatments, and increases with longer NPVA duration..
| Medienart: |
Artikel |
|---|
| Erscheinungsjahr: |
2019 |
|---|---|
| Erschienen: |
2019 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:35 |
|---|---|
| Enthalten in: |
Pediatric nephrology - 35(2019), 2 vom: 06. Nov., Seite 287-295 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Onder, Ali Mirza [VerfasserIn] |
|---|
| Links: |
Volltext [lizenzpflichtig] |
|---|
| Themen: |
Arteriovenous fistula |
|---|
| Anmerkungen: |
© IPNA 2019 |
|---|
| doi: |
10.1007/s00467-019-04396-3 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
OLC2056918390 |
|---|
| LEADER | 01000caa a22002652 4500 | ||
|---|---|---|---|
| 001 | OLC2056918390 | ||
| 003 | DE-627 | ||
| 005 | 20230502105649.0 | ||
| 007 | tu | ||
| 008 | 200820s2019 xx ||||| 00| ||eng c | ||
| 024 | 7 | |a 10.1007/s00467-019-04396-3 |2 doi | |
| 035 | |a (DE-627)OLC2056918390 | ||
| 035 | |a (DE-He213)s00467-019-04396-3-p | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 082 | 0 | 4 | |a 610 |q VZ |
| 100 | 1 | |a Onder, Ali Mirza |e verfasserin |0 (orcid)0000-0002-5225-0525 |4 aut | |
| 245 | 1 | 0 | |a Predictors of time to first cannulation for arteriovenous fistula in pediatric hemodialysis patients: Midwest Pediatric Nephrology Consortium study |
| 264 | 1 | |c 2019 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ohne Hilfsmittel zu benutzen |b n |2 rdamedia | ||
| 338 | |a Band |b nc |2 rdacarrier | ||
| 500 | |a © IPNA 2019 | ||
| 520 | |a Background Permanent vascular access (PVA) is preferred for long-term hemodialysis. Arteriovenous fistulae (AVF) have the best patency and the lowest complication rates compared to arteriovenous grafts (AVG) and tunneled cuffed catheters (TCC). However, AVF need time to mature. This study aimed to investigate predictors of time to first cannulation for AVF in pediatric hemodialysis patients. Methods Data on first AVF and AVG of patients at 20 pediatric dialysis centers were collected retrospectively, including demographics, clinical information, dialysis markers, and surgical data. Statistical modeling was used to investigate predictors of outcome. Results First PVA was created in 117 children: 103 (88%) AVF and 14 (12%) AVG. Mean age at AVF creation was 15.0 ± 3.3 years. AVF successfully matured in 89 children (86.4%), and mean time to first cannulation was 3.6 ± 2.5 months. In a multivariable regression model, study center, age, duration of non-permanent vascular access (NPVA), and Kt/V at AVF creation predicted time to first cannulation, with study center as the strongest predictor (p < 0.01). Time to first cannulation decreased with increasing age (p = 0.03) and with increasing Kt/V (p = 0.01), and increased with duration of NPVA (p = 0.03). Secondary failure occurred in 10 AVF (11.8%). Time to first cannulation did not predict secondary failure (p = 0.29), but longer time to first cannulation tended towards longer secondary patency (p = 0.06). Conclusions Study center is the strongest predictor of time to first cannulation for AVF and deserves further investigation. Time to first cannulation is significantly shorter in older children, with more efficient dialysis treatments, and increases with longer NPVA duration. | ||
| 650 | 4 | |a Hemodialysis | |
| 650 | 4 | |a Pediatric | |
| 650 | 4 | |a Arteriovenous fistula | |
| 650 | 4 | |a Arteriovenous graft | |
| 650 | 4 | |a Time to first cannulation | |
| 650 | 4 | |a Maturation time | |
| 700 | 1 | |a Flynn, Joseph T. |4 aut | |
| 700 | 1 | |a Billings, Anthony A. |4 aut | |
| 700 | 1 | |a Deng, Fang |4 aut | |
| 700 | 1 | |a DeFreitas, Marissa |4 aut | |
| 700 | 1 | |a Katsoufis, Chryso |4 aut | |
| 700 | 1 | |a Grinsell, Matthew M. |4 aut | |
| 700 | 1 | |a Patterson, Larry |4 aut | |
| 700 | 1 | |a Jetton, Jennifer |4 aut | |
| 700 | 1 | |a Fathallah-Shaykh, Sahar |4 aut | |
| 700 | 1 | |a Ranch, Daniel |4 aut | |
| 700 | 1 | |a Aviles, Diego |4 aut | |
| 700 | 1 | |a Copelovitch, Lawrence |4 aut | |
| 700 | 1 | |a Ellis, Eileen |4 aut | |
| 700 | 1 | |a Chadha, Vimal |4 aut | |
| 700 | 1 | |a Elmaghrabi, Ayah |4 aut | |
| 700 | 1 | |a Lin, Jen-Jar |4 aut | |
| 700 | 1 | |a Butani, Lavjay |4 aut | |
| 700 | 1 | |a Haddad, Maha |4 aut | |
| 700 | 1 | |a Marsenic, Olivera |4 aut | |
| 700 | 1 | |a Brakeman, Paul |4 aut | |
| 700 | 1 | |a Quigley, Raymond |4 aut | |
| 700 | 1 | |a Shin, H. Stella |4 aut | |
| 700 | 1 | |a Garro, Rouba |4 aut | |
| 700 | 1 | |a Liu, Hui |4 aut | |
| 700 | 1 | |a Rahimikollu, Javad |4 aut | |
| 700 | 1 | |a Raina, Rupesh |4 aut | |
| 700 | 1 | |a Langman, Craig B. |4 aut | |
| 700 | 1 | |a Wood, Ellen |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Pediatric nephrology |d Springer Berlin Heidelberg, 1987 |g 35(2019), 2 vom: 06. Nov., Seite 287-295 |w (DE-627)130424285 |w (DE-600)631932-4 |w (DE-576)015925064 |x 0931-041X |7 nnns |
| 773 | 1 | 8 | |g volume:35 |g year:2019 |g number:2 |g day:06 |g month:11 |g pages:287-295 |
| 856 | 4 | 1 | |u https://doi.org/10.1007/s00467-019-04396-3 |z lizenzpflichtig |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a SYSFLAG_A | ||
| 912 | |a GBV_OLC | ||
| 912 | |a GBV_ILN_2018 | ||
| 912 | |a GBV_ILN_4112 | ||
| 912 | |a GBV_ILN_4219 | ||
| 912 | |a GBV_ILN_4277 | ||
| 951 | |a AR | ||
| 952 | |d 35 |j 2019 |e 2 |b 06 |c 11 |h 287-295 | ||