Abstract: PO1024
The Association of Incremental Hemodialysis with Complications of Arteriovenous Access
Session Information
- Vascular Access Arena: Challenges, Progress, and Prospects
November 04, 2021 | Location: On-Demand, Virtual Only
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 703 Dialysis: Vascular Access
Authors
- Wang, Mengjing, Huashan Hospital Fudan University, Shanghai, Shanghai, China
- Chen, Jing, Huashan Hospital Fudan University, Shanghai, Shanghai, China
Background
Protection of arteriovenous vascular access by incremental hemodialysis was not examined. We conducted a historical cohort study to investigate the association of incremental hemodialysis with complications of arteriovenous access among incident hemodialysis patients.
Methods
Incident hemodialysis patients from Huashan hospital in Shanghai, China, over the period of 2012 to 2019 were enrolled and followed every three months. Complications of arteriovenous access included surgical interventions for failure, stenosis, or thrombosis. The risks of time to first complication of arteriovenous access for incremental versus conventional hemodialysis were examined by cox proportional hazards models. The risk of time to recurrent complications of arteriovenous access was examined by Andersen-Gill model (AG model) and Prentice, Williams and Peterson model (PWP-TT model).
Results
Of the 113 patients enrolled in the study, 45 patients underwent incremental and 68 conventional hemodialysis. The incidence rates of arteriovenous access complications between groups were 8.5 and 29.8 per 100 person-years, respectively. A decrease in risk for having an arteriovenous access complication was also observed for incremental hemodialysis by Cox models with an adjusted HR of 0.26 (95% CI, 0.08-0.82). Moreover, the adjusted risk of recurrent complications of arteriovenous access for incremental hemodialysis decreased in AG model (HR, 0.27; 95% CI, 0.10 – 0.74; P = 0.01) and in PWP-TT model (HR, 0.31; 95% CI, 0.12 – 0.80; P = 0.02) after multiple adjustments.
Conclusion
Incremental hemodialysis was significantly associated with reduced complications of arteriovenous access.
Unadjusted and adjusted Hazard Ratio of Arteriovenous access complications by hemodialysis regimens
| Model | Hazard Ratio | 95% Confidential Interval | P |
| Cox Model | |||
| Univariate | 0.36 | 0.13, 0.98 | 0.04 |
| Model 1 | 0.27 | 0.09, 0.81 | 0.02 |
| Model 2 | 0.26 | 0.08, 0.82 | 0.02 |
| AG Model | |||
| Univariate | 0.29 | 0.11, 0.79 | 0.02 |
| Model 1 | 0.25 | 0.10, 0.63 | 0.003 |
| Model 2 | 0.27 | 0.10, 0.74 | 0.01 |
| PWP-TT Model | |||
| Univariate | 0.37 | 0.16, 0.86 | 0.02 |
| Model 1 | 0.30 | 0.14, 0.66 | 0.003 |
| Model 2 | 0.31 | 0.12, 0.80 | 0.02 |