Annals of vascular surgery · 2025
Favorable Rates of Technical Success and Reintervention for Peritoneal Dialysis Compared to Hemodialysis.
СтатьяСравнительное исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Edsall Andrew, Shakhnovich Irina, Peterson Laura, Davis Clark, Fitzmaurice Isaiah, Murphy Ray, Pesonen Luke O
Аннотация
BACKGROUND: This study sought to evaluate technical outcomes of surgery for hemodialysis (HD) versus peritoneal dialysis (PD), and to assess the potential impact of early HD access creation.
METHODS: Retrospective review was conducted of all adult patients undergoing PD catheter placement or arterial-venous fistula/graft creation for initial dialysis access at a single center, January 2018-August 2023. Outcomes were assessed for patients undergoing PD versus HD, along with the association between time to first use of an arteriovenous (AV) fistula/graft and time to failure.
RESULTS: During the study period, 271 patients underwent creation of an AV fistula/graft with 229 (85%) initiating HD, of which 180 (79%) successfully utilized their fistula/graft. A total of 76 patients underwent placement of a PD catheter with 74 (97%) initiating PD, of which 70 (95%) successfully utilized their PD catheter. Median time from initial surgery to first successful use of dialysis access was 92 days for AV fistulas/grafts, versus 25 days for PD catheters (P < 0.001). Among patients who successfully accessed their AV fistula/graft or PD catheter, a significant difference was observed in rates of reintervention (HD 70% versus PD 44%, P < 0.001). Median time from initial surgery to reintervention was 166 days for AV fistulas/grafts, compared to 331 days for PD catheters (P = 0.026). No association was observed between time from fistula/graft creation to first use and time from first use to failure (P = 0.84).
CONCLUSION: Significant differences in technical outcomes exist between HD and PD, while early creation of HD access may not be associated with length of useable access life.
METHODS: Retrospective review was conducted of all adult patients undergoing PD catheter placement or arterial-venous fistula/graft creation for initial dialysis access at a single center, January 2018-August 2023. Outcomes were assessed for patients undergoing PD versus HD, along with the association between time to first use of an arteriovenous (AV) fistula/graft and time to failure.
RESULTS: During the study period, 271 patients underwent creation of an AV fistula/graft with 229 (85%) initiating HD, of which 180 (79%) successfully utilized their fistula/graft. A total of 76 patients underwent placement of a PD catheter with 74 (97%) initiating PD, of which 70 (95%) successfully utilized their PD catheter. Median time from initial surgery to first successful use of dialysis access was 92 days for AV fistulas/grafts, versus 25 days for PD catheters (P < 0.001). Among patients who successfully accessed their AV fistula/graft or PD catheter, a significant difference was observed in rates of reintervention (HD 70% versus PD 44%, P < 0.001). Median time from initial surgery to reintervention was 166 days for AV fistulas/grafts, compared to 331 days for PD catheters (P = 0.026). No association was observed between time from fistula/graft creation to first use and time from first use to failure (P = 0.84).
CONCLUSION: Significant differences in technical outcomes exist between HD and PD, while early creation of HD access may not be associated with length of useable access life.