Kidney Week

Abstract: SA-PO966

Differential Impact of Central Venous Catheters versus Arteriovenous Fistulas on Quality of Life Among Irish Haemodialysis Patients

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

• Browne, Leonard, Graduate Entry Medical School, University of Limerick, Limerick, Ireland

Leonard Browne,

• Ahmed, Gasim, Graduate Entry Medical School, University of Limerick, Limerick, Ireland

Gasim Ahmed,

• O'Sullivan, Aidan G., University of Limerick, Limerick, Ireland

Aidan G. O'Sullivan,

• White, Eoin J., University of Limerick, Limerick, Ireland

Eoin J. White,

• Mohammed, Elshaeima, Graduate Entry Medical School, University of Limerick, Limerick, Ireland

Elshaeima Mohammed,

• Leahy, Fiona, University Hospital Limerick, Limerick, Ireland

Fiona Leahy,

• Conway, Elaine C., University of Limerick, Limerick, Ireland

Elaine C. Conway,

• Ryan, Maria, University of Limerick, Limerick, Ireland

Maria Ryan,

• Osullivan, Leonard William, University of Limerick, Limerick, Ireland

Leonard William Osullivan,

• Stack, Austin G., Graduate Entry Medical School, University of Limerick, Limerick, Ireland

Austin G. Stack,

Background

The arteriovenous fistula (AVF) is associated with superior clinical outcomes than central venous catheters (CVC) in haemodialysis (HD). Recent studies have questioned the relative benefits in survival and quality of life using an AVF strategy over a CVC strategy. We compared the attitudes and opinions of HD patients using an AVF versus a CVC in an Irish cohort.

Methods

A cross-sectional study was conducted in maintenance HD patients (n=119) at a centre-based HD programme in 2018. A validated Vascular Access Questionnaire wasused to measure and compare quality of life across key domains. Patient satisfaction between AVF and CVC was compared in physical functioning, social functioning and dialysis complications using Likert scale with a p-value of <0.05 indicating statistical significance. Comparisons between groups were conducted using student t test and multivariable logistic regression expressed as odds ratio and (95% Confidence intervals).

Results

Average age was 66.1 years, 52.1% were using AVF with 47.9% a CVC. Patients with an AVF experienced higher overall satisfaction scores than a CVC (6.2 vs 4.9, P<0.01), however AVF patients reported more problems with bleeding, swelling and bruising than CVC patients [2.9 (2.2) vs 1.6(1.4), 2.9 (2.1) vs 1.7 (1.5), and 3.6 (2.2 vs 1.8) respectively, all p<0.005]. In contrast CVC patients reported greater difficulties in bathing and showering than AVF (4.5 (2.3) vs 2.1 (1.8), p <0.001). In multivariable analysis, adjusting for demographic and clinical factors, dialysing with a CVC (vs AVF) was associated with less difficulties in physical functioning OR, 0.35 (0.13-0.96), P=0.04, and higher odds of dialysis complications OR, 2.14 (0.78-5.89), P=0.1.

Conclusion

Compared to AVF, CVC use is associated with less physical complaints from bleeding and bruising but greater negative impact on social activities including bathing and showering. Minimising the impact of these on QOL should be considered in any long term vascular access strategy.

Funding

• Government Support - Non-U.S.