Impact of the vascular access on morbidity and mortality in chronic hemodialysis patients

Abstract

Background: 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. Vascular access is also known as a ‘lifeline’ for patients receiving hemodialysis (HD). 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. As a result, having a well‐functioning point of vascular access is very important. We aimed to study the prevelance of different types of vascular access and practice patterns at Ain Shams university hospitals and to study the impact of vascular access related problems on morbidity and mortality. Patients and Methods: This study is a prospective cohort study conducted in Ain shams university hospitals dialysis units in which all adults with end-stage kidney disease (ESRD) from the three units were included in the study. All patients were assessed as regard basic demographics, patient characteristics and vascular access characteristics. At the start of the study and then after one year data about vascular access related mortality and morbidity were collected. Statistical data analysis was done using SPSS (statistical package for the social sciences, version 2019, SPSS, Inc, Chicago, III, USA) Results: In our HD population where the majority of catheters were temporary nontunneled catheters, dialysis catheter use was associated with higher mortality and increased hospitalization rates compared with AV access. These results emphasize the urgent need to minimize the use of dialysis catheters.