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Predictors of patency for arteriovenous fistulae and grafts in pediatric hemodialysis patients

Background Hemodialysis (HD) guidelines recommend permanent vascular access (PVA) in children unlikely to receive kidney transplant within 1 year of starting HD. We aimed to determine predictors of primary and secondary patency of PVA in pediatric HD patients. Methods Retrospective chart reviews wer... Full description

Journal Title: Pediatric nephrology (Berlin West), 2018-09-27, Vol.34 (2), p.329-339
Main Author: Onder, Ali Mirza
Other Authors: Flynn, Joseph T , Billings, Anthony A , Deng, Fang , DeFreitas, Marissa , Katsoufis, Chryso , Grinsell, Matthew M , Patterson, Larry T , Jetton, Jennifer , Fathallah-Shaykh, Sahar , Ranch, Daniel , Aviles, Diego , Copelovitch, Lawrence , Ellis, Eileen , Chanda, Vimal , Elmaghrabi, Ayah , Lin, Jen-Jar , Butani, Lavjay , Haddad, Maha , Couloures, Olivera Marsenic , Brakeman, Paul , Quigley, Raymond , Stella Shin, H , Garro, Rouba , Liu, Hui , Rahimikollu, Javad , Raina, Rupesh , Langman, Craig B , Wood, Ellen G
Format: Electronic Article Electronic Article
Language: English
Subjects:
Publisher: Berlin/Heidelberg: Springer Berlin Heidelberg
ID: ISSN: 0931-041X
Link: https://www.ncbi.nlm.nih.gov/pubmed/30264215
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title: Predictors of patency for arteriovenous fistulae and grafts in pediatric hemodialysis patients
format: Article
creator:
  • Onder, Ali Mirza
  • Flynn, Joseph T
  • Billings, Anthony A
  • Deng, Fang
  • DeFreitas, Marissa
  • Katsoufis, Chryso
  • Grinsell, Matthew M
  • Patterson, Larry T
  • Jetton, Jennifer
  • Fathallah-Shaykh, Sahar
  • Ranch, Daniel
  • Aviles, Diego
  • Copelovitch, Lawrence
  • Ellis, Eileen
  • Chanda, Vimal
  • Elmaghrabi, Ayah
  • Lin, Jen-Jar
  • Butani, Lavjay
  • Haddad, Maha
  • Couloures, Olivera Marsenic
  • Brakeman, Paul
  • Quigley, Raymond
  • Stella Shin, H
  • Garro, Rouba
  • Liu, Hui
  • Rahimikollu, Javad
  • Raina, Rupesh
  • Langman, Craig B
  • Wood, Ellen G
subjects:
  • Adolescent
  • Arteriovenous Shunt, Surgical - adverse effects
  • Canada
  • Child
  • Children
  • Comparative analysis
  • Demography
  • Diseases
  • Female
  • Femur
  • Fistula, Arteriovenous
  • Fistulae
  • Hemodialysis
  • Hemodialysis patients
  • Humans
  • Intervention
  • Kidney Failure, Chronic - therapy
  • Kidney transplantation
  • Male
  • Medicine
  • Medicine & Public Health
  • Nephrology
  • Original Article
  • Patient outcomes
  • Pediatrics
  • Renal Dialysis - adverse effects
  • Renal Dialysis - methods
  • Retrospective Studies
  • Risk Factors
  • Statistical analysis
  • Survival
  • Time Factors
  • Treatment Failure
  • United States
  • Urology
  • Vascular Grafting - adverse effects
  • Vascular grafts
  • Vascular Patency
  • What's New in Dialysis
ispartof: Pediatric nephrology (Berlin, West), 2018-09-27, Vol.34 (2), p.329-339
description: Background Hemodialysis (HD) guidelines recommend permanent vascular access (PVA) in children unlikely to receive kidney transplant within 1 year of starting HD. We aimed to determine predictors of primary and secondary patency of PVA in pediatric HD patients. Methods Retrospective chart reviews were performed for first PVAs in 20 participating centers. Variables collected included patient demographics, complications, interventions, and final outcome. Results There were 103 arterio-venous fistulae (AVF) and 14 AV grafts (AVG). AVF demonstrated superior primary ( p  = 0.0391) and secondary patency ( p  = 0.0227) compared to AVG. Primary failure occurred in 16 PVA (13.6%) and secondary failure in 14 PVA (12.2%). AVF were more likely to have primary failure (odds ratio (OR) = 2.10) and AVG had more secondary failure (OR = 3.33). No demographic, clinical, or laboratory variable predicted primary failure of PVA. Anatomical location of PVA was predictive of secondary failure, with radial having the lowest risk compared to brachial (OR = 12.425) or femoral PVA (OR = 118.618). Intervention-free survival was predictive of secondary patency for all PVA ( p  = 0.0252) and directly correlated with overall survival of AVF ( p  = 0.0197) but not AVG. Study center demonstrated statistically significant effect only on intervention-free AVF survival ( p  = 0.0082), but not number of complications or interventions, or outcomes. Conclusions In this multi-center pediatric HD cohort, AVF demonstrated primary and secondary patency advantages over AVG. Radial PVA was least likely to develop secondary failure. Intervention-free survival was the only predictor of secondary patency for AVF and directly correlated with overall access survival. The study center effect on intervention-free survival of AVF deserves further investigation.
language: eng
source:
identifier: ISSN: 0931-041X
fulltext: no_fulltext
issn:
  • 0931-041X
  • 1432-198X
url: Link


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titlePredictors of patency for arteriovenous fistulae and grafts in pediatric hemodialysis patients
creatorOnder, Ali Mirza ; Flynn, Joseph T ; Billings, Anthony A ; Deng, Fang ; DeFreitas, Marissa ; Katsoufis, Chryso ; Grinsell, Matthew M ; Patterson, Larry T ; Jetton, Jennifer ; Fathallah-Shaykh, Sahar ; Ranch, Daniel ; Aviles, Diego ; Copelovitch, Lawrence ; Ellis, Eileen ; Chanda, Vimal ; Elmaghrabi, Ayah ; Lin, Jen-Jar ; Butani, Lavjay ; Haddad, Maha ; Couloures, Olivera Marsenic ; Brakeman, Paul ; Quigley, Raymond ; Stella Shin, H ; Garro, Rouba ; Liu, Hui ; Rahimikollu, Javad ; Raina, Rupesh ; Langman, Craig B ; Wood, Ellen G
creatorcontribOnder, Ali Mirza ; Flynn, Joseph T ; Billings, Anthony A ; Deng, Fang ; DeFreitas, Marissa ; Katsoufis, Chryso ; Grinsell, Matthew M ; Patterson, Larry T ; Jetton, Jennifer ; Fathallah-Shaykh, Sahar ; Ranch, Daniel ; Aviles, Diego ; Copelovitch, Lawrence ; Ellis, Eileen ; Chanda, Vimal ; Elmaghrabi, Ayah ; Lin, Jen-Jar ; Butani, Lavjay ; Haddad, Maha ; Couloures, Olivera Marsenic ; Brakeman, Paul ; Quigley, Raymond ; Stella Shin, H ; Garro, Rouba ; Liu, Hui ; Rahimikollu, Javad ; Raina, Rupesh ; Langman, Craig B ; Wood, Ellen G ; Midwest Pediatric Nephrology Consortium ; on behalf of the Midwest Pediatric Nephrology Consortium
descriptionBackground Hemodialysis (HD) guidelines recommend permanent vascular access (PVA) in children unlikely to receive kidney transplant within 1 year of starting HD. We aimed to determine predictors of primary and secondary patency of PVA in pediatric HD patients. Methods Retrospective chart reviews were performed for first PVAs in 20 participating centers. Variables collected included patient demographics, complications, interventions, and final outcome. Results There were 103 arterio-venous fistulae (AVF) and 14 AV grafts (AVG). AVF demonstrated superior primary ( p  = 0.0391) and secondary patency ( p  = 0.0227) compared to AVG. Primary failure occurred in 16 PVA (13.6%) and secondary failure in 14 PVA (12.2%). AVF were more likely to have primary failure (odds ratio (OR) = 2.10) and AVG had more secondary failure (OR = 3.33). No demographic, clinical, or laboratory variable predicted primary failure of PVA. Anatomical location of PVA was predictive of secondary failure, with radial having the lowest risk compared to brachial (OR = 12.425) or femoral PVA (OR = 118.618). Intervention-free survival was predictive of secondary patency for all PVA ( p  = 0.0252) and directly correlated with overall survival of AVF ( p  = 0.0197) but not AVG. Study center demonstrated statistically significant effect only on intervention-free AVF survival ( p  = 0.0082), but not number of complications or interventions, or outcomes. Conclusions In this multi-center pediatric HD cohort, AVF demonstrated primary and secondary patency advantages over AVG. Radial PVA was least likely to develop secondary failure. Intervention-free survival was the only predictor of secondary patency for AVF and directly correlated with overall access survival. The study center effect on intervention-free survival of AVF deserves further investigation.
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0ISSN: 0931-041X
1EISSN: 1432-198X
2DOI: 10.1007/s00467-018-4082-4
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languageeng
publisherBerlin/Heidelberg: Springer Berlin Heidelberg
subjectAdolescent ; Arteriovenous Shunt, Surgical - adverse effects ; Canada ; Child ; Children ; Comparative analysis ; Demography ; Diseases ; Female ; Femur ; Fistula, Arteriovenous ; Fistulae ; Hemodialysis ; Hemodialysis patients ; Humans ; Intervention ; Kidney Failure, Chronic - therapy ; Kidney transplantation ; Male ; Medicine ; Medicine & Public Health ; Nephrology ; Original Article ; Patient outcomes ; Pediatrics ; Renal Dialysis - adverse effects ; Renal Dialysis - methods ; Retrospective Studies ; Risk Factors ; Statistical analysis ; Survival ; Time Factors ; Treatment Failure ; United States ; Urology ; Vascular Grafting - adverse effects ; Vascular grafts ; Vascular Patency ; What's New in Dialysis
ispartofPediatric nephrology (Berlin, West), 2018-09-27, Vol.34 (2), p.329-339
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1Flynn, Joseph T
2Billings, Anthony A
3Deng, Fang
4DeFreitas, Marissa
5Katsoufis, Chryso
6Grinsell, Matthew M
7Patterson, Larry T
8Jetton, Jennifer
9Fathallah-Shaykh, Sahar
10Ranch, Daniel
11Aviles, Diego
12Copelovitch, Lawrence
13Ellis, Eileen
14Chanda, Vimal
15Elmaghrabi, Ayah
16Lin, Jen-Jar
17Butani, Lavjay
18Haddad, Maha
19Couloures, Olivera Marsenic
20Brakeman, Paul
21Quigley, Raymond
22Stella Shin, H
23Garro, Rouba
24Liu, Hui
25Rahimikollu, Javad
26Raina, Rupesh
27Langman, Craig B
28Wood, Ellen G
29Midwest Pediatric Nephrology Consortium
30on behalf of the Midwest Pediatric Nephrology Consortium
title
0Predictors of patency for arteriovenous fistulae and grafts in pediatric hemodialysis patients
1Pediatric nephrology (Berlin, West)
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0Pediatr Nephrol
1Pediatr Nephrol
descriptionBackground Hemodialysis (HD) guidelines recommend permanent vascular access (PVA) in children unlikely to receive kidney transplant within 1 year of starting HD. We aimed to determine predictors of primary and secondary patency of PVA in pediatric HD patients. Methods Retrospective chart reviews were performed for first PVAs in 20 participating centers. Variables collected included patient demographics, complications, interventions, and final outcome. Results There were 103 arterio-venous fistulae (AVF) and 14 AV grafts (AVG). AVF demonstrated superior primary ( p  = 0.0391) and secondary patency ( p  = 0.0227) compared to AVG. Primary failure occurred in 16 PVA (13.6%) and secondary failure in 14 PVA (12.2%). AVF were more likely to have primary failure (odds ratio (OR) = 2.10) and AVG had more secondary failure (OR = 3.33). No demographic, clinical, or laboratory variable predicted primary failure of PVA. Anatomical location of PVA was predictive of secondary failure, with radial having the lowest risk compared to brachial (OR = 12.425) or femoral PVA (OR = 118.618). Intervention-free survival was predictive of secondary patency for all PVA ( p  = 0.0252) and directly correlated with overall survival of AVF ( p  = 0.0197) but not AVG. Study center demonstrated statistically significant effect only on intervention-free AVF survival ( p  = 0.0082), but not number of complications or interventions, or outcomes. Conclusions In this multi-center pediatric HD cohort, AVF demonstrated primary and secondary patency advantages over AVG. Radial PVA was least likely to develop secondary failure. Intervention-free survival was the only predictor of secondary patency for AVF and directly correlated with overall access survival. The study center effect on intervention-free survival of AVF deserves further investigation.
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1Arteriovenous Shunt, Surgical - adverse effects
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3Child
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5Comparative analysis
6Demography
7Diseases
8Female
9Femur
10Fistula, Arteriovenous
11Fistulae
12Hemodialysis
13Hemodialysis patients
14Humans
15Intervention
16Kidney Failure, Chronic - therapy
17Kidney transplantation
18Male
19Medicine
20Medicine & Public Health
21Nephrology
22Original Article
23Patient outcomes
24Pediatrics
25Renal Dialysis - adverse effects
26Renal Dialysis - methods
27Retrospective Studies
28Risk Factors
29Statistical analysis
30Survival
31Time Factors
32Treatment Failure
33United States
34Urology
35Vascular Grafting - adverse effects
36Vascular grafts
37Vascular Patency
38What's New in Dialysis
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8Jetton, Jennifer
9Fathallah-Shaykh, Sahar
10Ranch, Daniel
11Aviles, Diego
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13Ellis, Eileen
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15Elmaghrabi, Ayah
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18Haddad, Maha
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21Quigley, Raymond
22Stella Shin, H
23Garro, Rouba
24Liu, Hui
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titlePredictors of patency for arteriovenous fistulae and grafts in pediatric hemodialysis patients
authorOnder, Ali Mirza ; Flynn, Joseph T ; Billings, Anthony A ; Deng, Fang ; DeFreitas, Marissa ; Katsoufis, Chryso ; Grinsell, Matthew M ; Patterson, Larry T ; Jetton, Jennifer ; Fathallah-Shaykh, Sahar ; Ranch, Daniel ; Aviles, Diego ; Copelovitch, Lawrence ; Ellis, Eileen ; Chanda, Vimal ; Elmaghrabi, Ayah ; Lin, Jen-Jar ; Butani, Lavjay ; Haddad, Maha ; Couloures, Olivera Marsenic ; Brakeman, Paul ; Quigley, Raymond ; Stella Shin, H ; Garro, Rouba ; Liu, Hui ; Rahimikollu, Javad ; Raina, Rupesh ; Langman, Craig B ; Wood, Ellen G
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0Adolescent
1Arteriovenous Shunt, Surgical - adverse effects
2Canada
3Child
4Children
5Comparative analysis
6Demography
7Diseases
8Female
9Femur
10Fistula, Arteriovenous
11Fistulae
12Hemodialysis
13Hemodialysis patients
14Humans
15Intervention
16Kidney Failure, Chronic - therapy
17Kidney transplantation
18Male
19Medicine
20Medicine & Public Health
21Nephrology
22Original Article
23Patient outcomes
24Pediatrics
25Renal Dialysis - adverse effects
26Renal Dialysis - methods
27Retrospective Studies
28Risk Factors
29Statistical analysis
30Survival
31Time Factors
32Treatment Failure
33United States
34Urology
35Vascular Grafting - adverse effects
36Vascular grafts
37Vascular Patency
38What's New in Dialysis
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2Billings, Anthony A
3Deng, Fang
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5Katsoufis, Chryso
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8Jetton, Jennifer
9Fathallah-Shaykh, Sahar
10Ranch, Daniel
11Aviles, Diego
12Copelovitch, Lawrence
13Ellis, Eileen
14Chanda, Vimal
15Elmaghrabi, Ayah
16Lin, Jen-Jar
17Butani, Lavjay
18Haddad, Maha
19Couloures, Olivera Marsenic
20Brakeman, Paul
21Quigley, Raymond
22Stella Shin, H
23Garro, Rouba
24Liu, Hui
25Rahimikollu, Javad
26Raina, Rupesh
27Langman, Craig B
28Wood, Ellen G
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8Jetton, Jennifer
9Fathallah-Shaykh, Sahar
10Ranch, Daniel
11Aviles, Diego
12Copelovitch, Lawrence
13Ellis, Eileen
14Chanda, Vimal
15Elmaghrabi, Ayah
16Lin, Jen-Jar
17Butani, Lavjay
18Haddad, Maha
19Couloures, Olivera Marsenic
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21Quigley, Raymond
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24Liu, Hui
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abstractBackground Hemodialysis (HD) guidelines recommend permanent vascular access (PVA) in children unlikely to receive kidney transplant within 1 year of starting HD. We aimed to determine predictors of primary and secondary patency of PVA in pediatric HD patients. Methods Retrospective chart reviews were performed for first PVAs in 20 participating centers. Variables collected included patient demographics, complications, interventions, and final outcome. Results There were 103 arterio-venous fistulae (AVF) and 14 AV grafts (AVG). AVF demonstrated superior primary ( p  = 0.0391) and secondary patency ( p  = 0.0227) compared to AVG. Primary failure occurred in 16 PVA (13.6%) and secondary failure in 14 PVA (12.2%). AVF were more likely to have primary failure (odds ratio (OR) = 2.10) and AVG had more secondary failure (OR = 3.33). No demographic, clinical, or laboratory variable predicted primary failure of PVA. Anatomical location of PVA was predictive of secondary failure, with radial having the lowest risk compared to brachial (OR = 12.425) or femoral PVA (OR = 118.618). Intervention-free survival was predictive of secondary patency for all PVA ( p  = 0.0252) and directly correlated with overall survival of AVF ( p  = 0.0197) but not AVG. Study center demonstrated statistically significant effect only on intervention-free AVF survival ( p  = 0.0082), but not number of complications or interventions, or outcomes. Conclusions In this multi-center pediatric HD cohort, AVF demonstrated primary and secondary patency advantages over AVG. Radial PVA was least likely to develop secondary failure. Intervention-free survival was the only predictor of secondary patency for AVF and directly correlated with overall access survival. The study center effect on intervention-free survival of AVF deserves further investigation.
copBerlin/Heidelberg
pubSpringer Berlin Heidelberg
pmid30264215
doi10.1007/s00467-018-4082-4
orcididhttps://orcid.org/0000-0002-5225-0525