Son dönem böbrek yetmezliği olan 735 hastada ilk vasküler erişim yolu olarak santral venöz kateter ile arteriyovenöz fistülün karşılaştırılması

Abstract

Amaç: Arteriyovenöz fistül (AVF), hemodiyaliz (HD) için ilk seçenek olarak gösterilse de risk faktörleri göz önüne alındığında santral venöz kateter (CVC)’ye üstünlüğü halen tartışma konusudur. Bu çalışmanın amacı ile HD de ilk vasküler erişim yolu olarak kullanılması gereken AVF ile CVC’nin karşılaştırılmasıydı. Gereç ve Yöntemler: Hastalar AVF ve CVC kullanımına göre iki gruba ayrıldı. Gruplar yaş, cinsiyet, vücut kitle endeksi (BMI), komorbiditeleri, antiplatelet ve antikoagülan ajan kullanımı, haftalık HD seansı, son dönem böbrek yetmezliği (ESRD) süresi, HD tedavi süresi, vasküler erişim yolu patens süresi ve değişim sayıları açısından karşılaştırıldı. Bulgular: 499 hasta CVC grubunda, 235 hasta AVF grubunda idi. AVF grubunun yaş ortalaması CVC grubundan daha fazla idi (p=0.010). CVC ve AVF grubu arasındaki ESRD süresideki farklılık anlamlı idi (5 ve 6 ay) (p=0.004). AVF grubunun HD tedavi süresi anlamlı olarak daha uzun idi (p=0.031). CVC’lerin median patens süresi 3 ay iken AVF’lerin patens süresi48 ay idi (p<0.001). CVC grubunda ortalama değişim sayısı 1 iken AVF grubunun ortalama değişim süresi 0 idi ve bu fark istatistiksel olarak anlamlı idi (p<0.001). Sonuçlar: AVF, patens süresi ve değişim sayısın açısından CVC’den daha üstindür ve HD tedavisinde ilk vasküler erişim yolu olarak tercih edilmelidir.

Keywords

• böbrek yetmezliği
• renal diyaliz
• arteriyovenöz fistül
• santral venöz kateter
• hemodiyaliz

Comparison of use of central venous catheter and arteriovenous fistula as initial vascular access in 735 patıents with end-stage renal disease

Abstract

Aim: Although arteriovenous fistula (AVF) has been shown as the first choice for hemodialysis (HD), its superiority over central venous catheter (CVC) is still controversial considering the risk factors. Aim was to compare AVF and CVC, which should be is used as the first vascular access in HD. Material and Methods: Patients were divided into two groups according to the use of AVF and CVC. The groups were compared in terms of age, gender, body mass index (BMI), comorbidities, use of antiplatelet and anticoagulant agents, HD sessions per week, end stage renal disease (ESRD) duration, HD treatment duration, patency of vascular acces and number of changes. Results: When patients were grouped, 499 patients were in the CVC group and 235 patients were in the AVF group. The mean age of patients in the AVF group was higher than that of the CVC group (p=0.010). The difference between the median ESRD duration of the patients in the CVC and AVF groups was statistically significant (5 vs 6 months) (p=0.004). The duration of HD treatment was significantly longer in the AVF group (p=0.031). The median patency of their CVC was 3 months, while the median patency of their AVF was 48 months (p<0.001). The median number of changes was 1in the CVC group and 0 in the AVF group, this difference was statistically significant (p<0.001). Conclusions: AVF is superior to CVC in terms of patency and number of changes, and it is the vascular access that should be preferred in first HD

Keywords

• kidney failure
• renal dialysis
• arteriovenous fistula
• central venous catheters
• hemodialysis.

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