Analysis of Follow-Up Methods of Vascular Access and Patient Outcomes in Hemodialysis at a Tertiary Care Hospital in China

作者：Zhang, Ying; Kong, Xianglei; Tang, Lijun; Wei, Yong; Xu, Dongmei^*

来源：Therapeutic Apheresis and Dialysis, 2018, 22(2): 160-165.

DOI：10.1111/1744-9987.12646

• Arteriovenous fistula
• Follow-up
• Hemodialysis
• Outcomes
• Vascular access

Arteriovenous fistula is the preferred option for vascular access in hemodialysis patients. The aim of this study was to assess different follow-up methods for hemodialysis patients in our hemodialysis center in China. A cohort of 124 patients with stage 3 chronic kidney disease was recruited and double-blind randomly assigned into two groups. Patients in Group A received phone calls to schedule their next consultation a week in advance. Patients in Group B scheduled their next appointment at the end of each visit. A total of 116 patients were included in the study and eight dropped out. Twenty-seven patients (46.4%) in Group A and 13 patients (22.4%) in Group B had an AVF prior to hemodialysis (P=0.006), and 44.8% of patients in Group A and 15.5% of patients in Group B were using AVFs at the initiation of dialysis (P=0.003). Sixteen patients (27.6%) in Group A and 24 patients (41.3%) in Group B required central venous catheters due to acute on chronic kidney disease and 13 patients (22.4%) in Group A and 21 patients (36.2%) in Group B required central venous catheters due to patient-related delays (P=0.02). At the end of the study, seven patients in Group A died and 17 patients in Group B died (P=0.027). The patients who received phone calls to schedule appointments in advance had a higher rate of arteriovenous fistulas prior to dialysis and at hemodialysis initiation had a reduced incidence of acute on chronic kidney disease and patient-related delays, and had an improved prognosis.

• 出版日期2018-4
• 单位山东省千佛山医院; 山东大学