Kidney Week

Abstract: SA-PO958

Predictors of Complications During Outpatient Dialysis Access Procedures

Session Information

• Dialysis: Vascular Access - II
  October 27, 2018 | Location: Exhibit Hall, San Diego Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Dialysis

• 704 Dialysis: Vascular Access

Authors

• Miller, Gregg, Azura Vascular Care, Malvern, Pennsylvania, United States

Gregg Miller,

• Koh, Elsie, Azura Vascular Care, Malvern, Pennsylvania, United States

Elsie Koh,

• Jiao, Yue, Fresenius Medical Care North America, Waltham, Massachusetts, United States

Yue Jiao,

• Rosen, Sophia, Fresenius Medical Care North America, Waltham, Massachusetts, United States

Sophia Rosen,

• Reviriego-Mendoza, Marta, Fresenius Medical Care North America, Waltham, Massachusetts, United States

Marta Reviriego-Mendoza,

• Larkin, John W., Fresenius Medical Care North America, Waltham, Massachusetts, United States

John W. Larkin,

• Usvyat, Len A., Fresenius Medical Care North America, Waltham, Massachusetts, United States

Len A. Usvyat,

• Mclaughlin, Nancy, Azura Vascular Care, Malvern, Pennsylvania, United States

Nancy Mclaughlin,

• Madormo, Catherina, Azura Vascular Care, Malvern, Pennsylvania, United States

Catherina Madormo,

• Sor, Murat, Azura Vascular Care, Malvern, Pennsylvania, United States

Murat Sor,

• Maddux, Franklin W., Fresenius Medical Care North America, Waltham, Massachusetts, United States

Franklin W. Maddux,

Background

It is unknown if patient specific factors contribute to complications during dialysis vascular access (VA) interventions. We detailed the characteristics of dialysis patients who underwent a VA procedure and investigated risk factors for perioperative complications.

Methods

We analyzed data from patients treated at a large dialysis provider who had ≥1 VA procedure at an affiliated freestanding outpatient access center during 2016 and 2017. The distribution of perioperative complications (e.g. adverse drug reactions, falls, post-operative infections, required interoperative airway management, medication/fluids, and/or additional surgery/procedure) was assessed across strata for age (≤30, 31-40, 41-50, 51-60, 61-70, 71-80, 81-90, >90 years), body mass index (BMI) (≤25, 26-30, 31-35, 36-40, 41-45, 46-50, >50 kg/m²), and hemoglobin (HgB) levels (<9, 9-<10, 10-<11, 11-<12, 12-<13, ≥13 g/dL). Chi-square tests were used to compare the percent (%) of complications within strata.

Results

We analyzed data from 29,322 unique dialysis patients who underwent a total of 100,070 VA procedures. The % of perioperative complications were evenly distributed for age (p=0.54) and BMI (p=0.09) strata (Figure 1 A & B). However, the % of perioperative complications was observed to be elevated for those with a HgB level <10 g/dL versus ≥10 g/dL (Figure 1 C; p<0.0001).

Conclusion

This research indicates that patients with low HgB levels may be at a higher risk for perioperative complications as compared to those with higher HgB levels; however, patients with low HgB levels are also at a higher risk of all-cause hospital admissions and mortality.

Funding

• Commercial Support – Fresenius Medical Care North America