COMPARING CREATININE TO UREA VOLUME (KT/V) AMONG ARTERIOVENOUS FISTULA, VASCULAR GRAFT, AND TUNNELED CUFFED CATHETERS: A RETROSPECTIVE STUDY

A HAIDER; MRA RAZZAQUE; AR KHAN

doi:10.54112/bcsrj.v2024i1.1059

Authors

A HAIDER Department of Nephrology, Sindh Infectious Disease Hospital and Research Center, Dow University of Health Sciences, Karachi, Pakistan
MRA RAZZAQUE Jinnah Medical and Dental College, Medicare Cardiac and General Hospital, Sohail University, Karachi, Pakistan
AR KHAN Methodist hospital, Houston, Texas , United States

DOI:

https://doi.org/10.54112/bcsrj.v2024i1.1059

Keywords:

Arteriovenous Fistula, Dialysis, Permanent Catheter, Pakistan, Vascular Graft

Abstract

Hemodialysis patients may employ three different kinds of vascular access: permanent catheter (PC), arteriovenous fistula (AVF), and vascular graft (AVG). This research was done to compare AVF, AVG, and PC regarding dialysis adequacy since there is a lack of data on the subject. Methods: This was a two-year retrospective study. Two hundred hemodialysis patients participated in the research and were randomly allocated to one of three groups: AVF, AVG, or PC. Blood was drawn before and after a dialysis treatment to analyze the urea reduction ratio (URR) and creatinine to urea volume (Kt/V). Laboratory tests were redone after six months of monitoring the patients. Results: A total of 200 patients were divided into three groups based on the type of vascular access: AVF (n=137), AVG (n=36), and PC (n=27). The Mean ± S.D of the patient's age in AVF, AVG, and PC were 58.6±14.7, 60.5±0.5, and 53.6±25.0 years respectively. The Mean ± S.D of Kt/v in AVF, AVG, and PC were 1.2±0.3, 1.4±0.2, and 1.1±0.4 respectively. A significant Variation (p=0.012) in the mean Kt/v of the study groups was observed in the present study. The Mean ± S.D of URR in AVF, AVG and PC were 64.3±7.9, 69.1±3.1, and 62.8±5.1 respectively. A significant Variation (p=0.000) in the mean URR of the study groups was observed in the present study. Conclusion: AVF and AVG have superior hemodialysis adequacy regarding Kt/v and URR over PC.

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References

Schwab SJ, Buller GL, McCann RL, Bollinqer RR, Stickel DL. Prospective evaluation of a Dacron cuffed hemodialysis catheter for prolonged use. American Journal of Kidney Diseases. 1988;11(2):166-9.

Suhocki PV, Conlon Jr PJ, Knelson MH, Harland R, Schwab SJ. Silastic cuffed catheters for hemodialysis vascular access: thrombolytic and mechanical correction of malfunction. American journal of kidney diseases. 1996;28(3):379-86.

Paglialonga F, Consolo S, Biasuzzi A, Assomou J, Gattarello E, Patricelli MG, et al. Reduction in catheter‐related infections after switching from povidone‐iodine to chlorhexidine for the exit‐site care of tunneled central venous catheters in children on hemodialysis. Hemodialysis International. 2014;18:S13-S8.

Pisoni RL, Young EW, Dykstra DM, Greenwood RN, Hecking E, Gillespie B, et al. Vascular access use in Europe and the United States: results from the DOPPS. Kidney international. 2002;61(1):305-16.

Tordoir J, Canaud B, Haage P, Konner K, Basci A, Fouque D, et al. EBPG on vascular access. Nephrology Dialysis Transplantation. 2007;22(suppl_2):ii88-ii117.

Lopot F, Malík J, Švára F, Polakovič V. Changes in vascular access blood flow: etiological factors and clinical implications. The Journal of Vascular Access. 2021;22(4):575-84.

Xue JL, Dahl D, Ebben JP, Collins AJ. The association of initial hemodialysis access type with mortality outcomes in elderly Medicare ESRD patients. American journal of kidney diseases. 2003;42(5):1013-9.

Astor BC, Eustace JA, Powe NR, Klag MJ, Fink NE, Coresh J. Type of vascular access and survival among incident hemodialysis patients: the Choices for Healthy Outcomes in Caring for ESRD (CHOICE) Study. Journal of the American Society of Nephrology. 2005;16(5):1449-55.

Cortez AJ, Paulson WD, Schwab SJ, editors. Vascular access as a determinant of adequacy of dialysis. Seminars in nephrology; 2005: Elsevier.

Kjellstrand CM, Blagg CR, Twardowski ZJ, Bower J. Blood access and daily hemodialysis: clinical experience and review of the literature. ASAIO journal. 2003;49(6):645-9.

Foundation NK. Clinical practice guidelines for vascular access: National Kidney Foundation; 1997.

Ifudu O, Mayers JD, Matthew JJ, Fowler A, Friedman EA. Haemodialysis dose is independent of type of surgically-created vascular access. Nephrology, dialysis, transplantation: official publication of the European Dialysis and Transplant Association-European Renal Association. 1998;13(9):2311-6.

Kukavica N, Resić H, Šahović V. Comparison of complications and dialysis adequacy between temporary and permanent tunnelled catheter for haemodialysis. Bosnian journal of basic medical sciences. 2009;9(4):265.

Ethier J, Mendelssohn DC, Elder SJ, Hasegawa T, Akizawa T, Akiba T, et al. Vascular access use and outcomes: an international perspective from the Dialysis Outcomes and Practice Patterns Study. Nephrology Dialysis Transplantation. 2008;23(10):3219-26.

Tonelli M, Muirhead N. Access type as a predictor of dialysis adequacy in chronic hemodialysis patients. ASAIO Journal. 2000;46(3):279-82.

Canaud B, Leray-Moragues H, Garrigues V, Mion C. Permanent twin catheter: a vascular access option of choice for haemodialysis in elderly patients. Nephrology, dialysis, transplantation: official publication of the European Dialysis and Transplant Association-European Renal Association. 1998;13(suppl_7):82-8.

Lee T, Barker J, Allon M. Comparison of survival of upper arm arteriovenous fistulas and grafts after failed forearm fistula. Journal of the American Society of Nephrology. 2007;18(6):1936-41.

Hicks CW, Canner JK, Arhuidese I, Zarkowsky DS, Qazi U, Reifsnyder T, et al. Mortality benefits of different hemodialysis access types are age dependent. Journal of vascular surgery. 2015;61(2):449-56.

Banerjee T, Kim SJ, Astor B, Shafi T, Coresh J, Powe NR. Vascular access type, inflammatory markers, and mortality in incident hemodialysis patients: the Choices for Healthy Outcomes in Caring for End-Stage Renal Disease (CHOICE) Study. American journal of kidney diseases. 2014;64(6):954-61.