الفهرس | Only 14 pages are availabe for public view |
Abstract Patients with end‐stage renal disease (ESRD) have high rates of mortality and morbidity. Adequate dialysis is essential to maintain a high quality of life and survival in these patients. Complications associated with vascular access result in frequent hospitalizations and often require intervention. These complications have significant impacts on the morbidity and mortality of dialysis patients, while also leading to high medical costs. Vascular access (VA) handling represents a major clinical issue in chronic hemodialysis (HD) patients because VA efficiency substantially affects dialysis adequacy and patient morbidity. Generally, the native arterovenous fistula (AVF) is considered the best access for chronic HD, but in some specific clinical conditions, such as acute renal failure, inadequate or exhausted vessels and reduced life expectancy, this choice can become infeasible. Recently, it has been demonstrated in retrospective studies that both central venous catheter (CVC) and arterovenous graft (AVG) use as permanent VA, is associated with a higher death risk in chronic HD patients when compared to AVF in populations. Cardiovascular events are the leading cause of death in chronic hemodialysis patients. Vascular access related problems may predispose to CVD, infections, thrombosis and access failure, bleeding risk, CTEPH, repeated hospitalization and death. So, we aimed to quantify the associations between vascular access type and mortality, infection, and cardiovascular events and assess the quality of available epidemiologic data. |