The Prognostic Significance of Puncture Timing to Survival of Arteriovenous Fistulas in Hemodialysis Patients: A Multicenter Retrospective Cohort Study

Journal of Clinical Medicine

卷:8

Tse-Chih Chou¹  Chun-Liang Lin²  Chun-Wu Tung²  Yung-Chien Hsu²  Ya-Hsueh Shih²  Su-Ju Lin²  Shu-Chen Chang³  Yi-Ling Wu³ 

[1] Clinical Informatics and Medical Statistics Research Center, Chang Gung University, Taoyuan 33302, Taiwan;

[2] Department of Nephrology, Chang Gung Memorial Hospital, Chiayi 61363, Taiwan;

[3] Research Services Center for Health Information, Chang Gung University, Taoyuan 33302, Taiwan;

关键词: arteriovenous fistula;    hemodialysis;    survival;    maturation time;    puncture time;   

DOI  :  10.3390/jcm8020247

来源: DOAJ

【 摘 要 】

(1) Background: A functional shunt is critical to hemodialysis, but the ideal timing of shunt cannulation is still not established. In this study, we assessed the association between ideal puncture timing and shunt survival. (2) Methods: This retrospective cohort study using data from the Taiwan Health and Welfare database, which included 26885 hemodialysis patients with arteriovenous fistulas from 1 July 2008 to 30 June 2012. Fistulas were categorized by functional maturation time, defined as the time from the date of shunt construction to the first successful cannulation. Functional cumulative survival, measured as the duration from the first puncture to shunt abandonment, was mainly regarded. (3) Results: The fistulas created between 91 and 180 days prior to the first cannulation had significantly greater cumulative functional survival (HR 0.883; 95% CI 0.792⁻0.984), and there was no more benefit on their survival from waiting more than 180 days (HR 0.957; 95% CI 0.853⁻1.073) for shunt maturity. (4) Conclusions: Our results showed that to achieve better long-term shunt survivals, fistulas should be constructed at least 90 days before starting hemodialysis. Notably, there was no additional benefit on waiting more than 180 days prior to cannulation.

【 授权许可】

Unknown