Vascular access complications in long-term pediatric hemodialysis patients.
Publication/Presentation Date
11-1-2008
Abstract
Current data demonstrate pediatric patients who remain on hemodialysis (HD) therapy are more likely to be dialyzed via central venous catheters (CVCs) than arteriovenous grafts (AVGs) and fistulae (AVFs). We retrospectively compared complications and health-related quality of life (HRQOL) associated with different vascular access types at two large centers over a 1-year period. Patients included in the study were younger than 25 years of age, weighed >20 kg, and had received HD for at least 3 months. Thirty CVC patients and 21 AVG/AVF patients received a total of 2,393 and 3,506 HD treatments, respectively. The infectious complication rate was higher for CVC patients, who were hospitalized 3.7 days for each 100 HD treatments versus 0.2 days for AVG/AVF patients (p < 0.01). CVC patients also had a much higher rate of access revision, needing 2.7 hospital days every 100 HD treatments compared with 0.2 days for AVG/AVF patients (p < 0.01). HRQOL scores did not differ between groups. Thus, despite similar HRQOL, CVCs were associated with more complications and greater morbidity when compared with AVG/AVFs. These findings further emphasize the need to use AVG/AVFs as primary HD access for pediatric patients expected to receive a long course of maintenance HD.
Volume
23
Issue
11
First Page
2061
Last Page
2065
ISSN
0931-041X
Published In/Presented At
Zaritsky, J. J., Salusky, I. B., Gales, B., Ramos, G., Atkinson, J., Allsteadt, A., Brandt, M. L., & Goldstein, S. L. (2008). Vascular access complications in long-term pediatric hemodialysis patients. Pediatric nephrology (Berlin, Germany), 23(11), 2061–2065. https://doi.org/10.1007/s00467-008-0956-1
Disciplines
Medicine and Health Sciences | Pediatrics
PubMedID
18712416
Department(s)
Department of Pediatrics
Document Type
Article