2026-04-03T21:11:58Zhttps://recercat.cat/oai/request

oai:recercat.cat:11351/72772025-10-24T08:28:35Zcom_2072_451660com_2072_378040col_2072_451662

Are continued policies of prioritizing native vascular access in patients on hemodialysis programs useful? Ibáñez Pallarès, Sara Velescu, Alina Tapia González, Irati Collado Nieto, Silvia Clara Velasco, Albert Esteve Simó, Vicent [Ibáñez Pallarès S] Vascular Surgery Department, Hospital de Terrassa, Barcelona, Spain. Surgery and Morphologic Sciences Department, Autonomous University of Barcelona (UAB), Barcelona, Spain. [Esteve Simó V] Nephrology Department, Hospital de Terrassa, Barcelona, Spain. [Velescu A, Clara Velasco A] Vascular Surgery Department, Hospital del Mar, Barcelona, Spain. [Tapia González I] Nephrology Department, Hospital de Terrassa, Barcelona, Spain. Medicine Department, Autonomous University of Barcelona, Barcelona, Spain. [Collado Nieto S] Nephrology Department, Hospital del Mar, Barcelona, Spain Consorci Sanitari de Terrassa Artèries Venes Dialisi ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Surgical Procedures, Operative::Anastomosis, Surgical::Arteriovenous Shunt, Surgical ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Therapeutics::Renal Replacement Therapy::Renal Dialysis ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Investigative Techniques::Epidemiologic Methods::Epidemiologic Study Characteristics::Epidemiologic Studies::Case-Control Studies::Retrospective Studies TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::intervenciones quirúrgicas::anastomosis quirúrgica::anastomosis quirúrgica arteriovenosa TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::terapéutica::tratamiento de reemplazo renal::diálisis renal TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::técnicas de investigación::métodos epidemiológicos::características de los estudios epidemiológicos::estudios epidemiológicos::estudios de casos y controles::estudios retrospectivos AV access; dialysis; Native vascular access; Survival Acceso AV; diálisis; Acceso vascular nativo; Supervivencia Accés AV; Diàlisi; Accés vascular natiu; Supervivència The guidelines recommend establishing native vascular access as opposed to prosthetic or catheter-based access despite information relating to its effectiveness being scarce from a patient-orientated perspective. We analyzed the effectiveness of a continued policy of native vascular access (CPNVA) in patients undergoing hemodialysis. A retrospective, observational study, including 150 patients undergoing hemodialysis between 2006 and 2012 at our center, and who underwent a CPNVA. Statistical analysis was based on treatment intention. In 138 patients (92%), the first useful access (FUA) was native, and in 12 patients (8%), it was prosthetic. In 50 patients (33.3%), more than one procedure had to be carried out in to order to achieve FUA. The probability of dialysis occurring via a FUA was 67.1% and 45.3% at 1 and 5 years respectively. Over the follow-up period (mean time = 30 months), 84 patients (56%) required repairs or new access, extending the effectiveness of the CPNVA to 88.3% and 73.2% at 1 and 5 years respectively. The effectiveness of the CPNVA was reduced if the patient: required a catheter initially (HR: 3.6, p = 0.007); in cases of initially elevated glomerular filtration rate (HR: 1.1, p = 0.040); in cases of history of previous access failure before FUA (HR: 3.9, p = 0.001); and in female patients (HR: 2.4, p = 0.031). The long-term effectiveness of a CPNVA is high. However, the percentage of patients requiring diverse procedures in order to achieve FUA and the need for re-interventions yield the necessity to optimize preoperative evaluation and postoperative follow-up. 2022-03-30T12:12:41Z 2022-03-30T12:12:41Z 2022-04 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion Ibáñez Pallarès S, Esteve Simó V, Velescu A, Tapia González I, Collado Nieto S, Clara Velasco A. Are continued policies of prioritizing native vascular access in patients on hemodialysis programs useful? Ther Apher Dial. 2022 Apr;26(2):434-440. https://hdl.handle.net/11351/7277 10.1111/1744-9987.13711 34296527 http://hdl.handle.net/11351/7277 eng Therapeutic Apheresis and Dialysis;26(2) https://doi.org/10.1111/1744-9987.13711 Attribution-NonCommercial-NoDerivatives 4.0 International http://creativecommons.org/licenses/by-nc-nd/4.0/ info:eu-repo/semantics/openAccess application/pdf Wiley Scientia