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Clinical course associated with vascular access type in a national cohort of adolescents who receive hemodialysis: findings from the Clinical Performance Measures and US Renal Data System projects.
- Source :
-
Clinical journal of the American Society of Nephrology : CJASN [Clin J Am Soc Nephrol] 2006 Sep; Vol. 1 (5), pp. 987-92. Date of Electronic Publication: 2006 Jul 26. - Publication Year :
- 2006
-
Abstract
- Limited research has described clinical outcomes that are associated with the type of vascular access in pediatric patients who receive maintenance hemodialysis. This retrospective cohort study examined prevalent pediatric patients who were aged 12 to <18 yr and identified in the 2000 ESRD Clinical Performance Measures Project as receiving in-center hemodialysis. Vascular access type as of December 31, 1999, was identified. These patients were linked with 1 yr of data (January 1, 2000, through December 31, 2000) from US Renal Data System standard analytic files that allow for the comparison of rates of hospitalizations and access complications by access type. Of the 418 patients who met inclusion criteria, the mean age was 15.6 yr, 53% were male, 49% were white, the mean time on dialysis was 22 mo, and 42% had a structural/urologic cause of ESRD; 42% of patients had an arteriovenous graft or fistula, and 58% had a vascular catheter. Patients with a vascular catheter as compared with those with a graft or fistula had the following adjusted relative risks (95% confidence interval): 1.84 (1.38 to 2.44) for hospitalization for any cause, 4.74 (2.02 to 11.14) for hospitalization as a result of infection, and 2.72 (2.00 to 3.69) for a complication of vascular access. Vascular catheters are the predominant access type in adolescent patients who receive maintenance hemodialysis and are associated with significantly more hospitalizations and complications.
- Subjects :
- Adolescent
Arteriovenous Shunt, Surgical statistics & numerical data
Blood Vessel Prosthesis Implantation statistics & numerical data
Catheterization statistics & numerical data
Cohort Studies
Female
Hospitalization statistics & numerical data
Humans
Kidney Failure, Chronic epidemiology
Male
Prognosis
Registries
Renal Dialysis statistics & numerical data
Retrospective Studies
Risk Assessment
United States epidemiology
Arteriovenous Shunt, Surgical adverse effects
Blood Vessel Prosthesis Implantation adverse effects
Catheterization adverse effects
Kidney Failure, Chronic therapy
Quality Indicators, Health Care statistics & numerical data
Renal Dialysis methods
Subjects
Details
- Language :
- English
- ISSN :
- 1555-905X
- Volume :
- 1
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- Clinical journal of the American Society of Nephrology : CJASN
- Publication Type :
- Academic Journal
- Accession number :
- 17699317
- Full Text :
- https://doi.org/10.2215/CJN.00530206