1. Vascular access type and prognosis in elderly hemodialysis patients: a propensity-score-matched study
- Author
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Ru-xin Liu, Shuai Lin, Li Liu, Juan Xu, Lin-na Liu, Jie Pang, Hai-wen An, Wen-qin Yang, Jian-lin Jian, Jin Wang, Zhi-lan He, Xiao-lan Luo, Hui Zou, Yuan Zeng, Qing-xiu Huang, and Yan-lin Li
- Subjects
Hemodialysis ,arteriovenous fistula ,tunneled cuffed catheter ,mortality ,propensity score matching ,Diseases of the genitourinary system. Urology ,RC870-923 - Abstract
Background To compare the impact of tunneled cuffed catheters (TCCs) and arteriovenous fistulas (AVFs) on outcomes in elderly hemodialysis (HD) patients.Methods A retrospective matched cohort study was performed. Propensity score matching (PSM) was applied to balance the baseline conditions, and we compared all-cause mortality, major adverse cardiovascular and cerebrovascular events (MACCEs), hospitalization, and infection rates between AVF and TCC patients ≥70 years old. Cox survival analysis was used to analyze the risk factors for death.Results There were 2119 patients from our center in the Chinese National Renal Data System (CNRDS) between 1 January 2010 and 10 October 2023. Among these patients, 77 TCC patients were matched with 77 AVF patients. There was no significant difference in all-cause mortality between the TCC and AVF groups (30.1/100 vs. 33.3/100 patient-years, p = 0.124). Among the propensity score-matched cohorts, no significant differences in Kaplan–Meier curves were observed between the two groups (log-rank p = 0.242). The TCC group had higher rates of MACCEs, hospitalization, and infection than the AVF group (33.7/100 vs. 29.5/100 patient-years, 101.2/100 vs. 79.5/100 patient-years, and 30.1/100 vs. 14.1/100 patient-years, respectively). Multivariate analysis showed that high Charlson comorbidity index (CCI) score was a risk factor for death.Conclusions There was no significant difference in all-cause mortality between elderly HD patients receiving TCCs and AVFs. Compared with those with a TCC, elderly HD patients with an AVF have a lower risk of MACCEs, hospitalization, and infection.
- Published
- 2024
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