Kidney Week

Abstract: FR-PO546

Vascular Access-Related Hospitalizations in Hemodialysis

Session Information

• Dialysis Vascular Access
  October 25, 2024 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Dialysis

• 803 Dialysis: Vascular Access

Authors

• Luzardo, Leonella, Uruguayan Dialysis Registry, Montevideo, Select a State/Province, Uruguay

Leonella Luzardo, MD

• Zinoveev, Maria Agustina, Uruguayan Dialysis Registry, Montevideo, Select a State/Province, Uruguay

Maria Agustina Zinoveev, MSc

• Ceretta, María Laura, Uruguayan Dialysis Registry, Montevideo, Select a State/Province, Uruguay

María Laura Ceretta

• Ferreiro, Alejandro, Uruguayan Dialysis Registry, Montevideo, Select a State/Province, Uruguay

Alejandro Ferreiro, MD

• Gonzalez-Bedat, Maria Carlota, Uruguayan Dialysis Registry, Montevideo, Select a State/Province, Uruguay

Maria Carlota Gonzalez-Bedat, MD

Background

Arteriovenous fistulas (AVF) are recommended for patients on HD due to their benefits over catheters(CAT), that are associated with higher morbidity. The aim of this research is to analyze vascular access–related hospitalizations.

Methods

We analyzed the HD cohort of patients on HD during 2022 in Uruguay. Data was extracted from the Uruguayan Dialysis Registry. Vascular access were divided into catheters (CAT) or arteriovenous grafts or fistulas(AV). Vascular access–related hospitalizations were classified into infectious or non-infectious and 4 categories were established: CAT-inf, CAT-non inf, AV-inf, AV-non inf. Those complications that did not require hospital admission were not included. We calculated the rate of admissions/1,000 HD sessions.

Results

A total of 3,472 patients (60.1% M; 66.2% diabetes) were included, 62.9 years (SD ± 16.2). 390,920 chronic HD sessions were performed, on 64.4% of them the vascular access was an AV graft or fistula. We analyzed 716 vascular access – related admissions (589 patients) and 69.7% of them were nonrelated to infection. The rate of admissions related to AVFs was 2,18/1000 HD session (95% CI: 2,00–2,36) and the rate of admissions related to CAT was 1,21/1000 HD session (95% CI:1,04–1,41). Hospitalizations due to an AV-non inf complication were the most frequent with a rate of 1,82/1000 HD session (table1). Patients who required admission had similar age (63.0vs62.7 years; p=ns) but had more diabetes (70.5% vs 60.4%; p=0.02).

Conclusion

Unexpectedly, mechanical complications of AVFs were responsible for most admissions. This is probably multifactorial and is related to the comorbidities of the population and a decrease in infectious complications of catheters due to their improvement. An analysis of the trend over the last years would be of interest for a better understanding of the complications associated with vascular access.

Table 1. Vascular access-related morbidity rate.

Admissions /1,000 HD sessions. AV-inf: arteriovenous graft or fistula infections; AV-non inf: arteriovenous graft or fistula non infection; CAT-inf: catheter related infections; CAT-non inf: catheter related non infection.