We use cookies to understand how you use our site and to improve your experience. This includes personalizing content and advertising. To learn more, click here. By continuing to use our site, you accept our use of cookies. Cookie Policy.

HospiMedica

Download Mobile App
Recent News AI Critical Care Surgical Techniques Patient Care Health IT Point of Care Business Focus

Catheters in Dialysis Linked to High Risk of Infection

By HospiMedica International staff writers
Posted on 03 Mar 2013
Print article
A new study shows that dialysis patients using catheters for blood access have the highest risks for death, infections, and cardiovascular (CV) events.

Researchers at the University of Calgary (Canada), the University of Otago (Christchurch, New Zealand), and other institutions conducted a systematic review of cohort studies to evaluate the associations between type of vascular access (arteriovenous fistula, arteriovenous graft, and central venous catheter) and risk for death, infection, and major CV events. The researchers searched MEDLINE, EMBASE, and other article reference lists and extracted data describing study design, participants, vascular access type, clinical outcomes, and risk for bias. In all, 62 cohort studies comprising 586,337 participants met the inclusion criteria.

The results showed that when compared with patients with an arteriovenous fistula, those using catheters had a 38% higher risk of experiencing a major heart-related event, a 53% higher risk of dying, and more than twice the risk of developing fatal infections. Patients with arteriovenous grafts had an 18% increased risk of dying and a 36% increased risk of developing fatal infections compared to those with an arteriovenous fistula, but they did not have an increased risk of experiencing a major heart-related event. The study was published early online on February 21, 2013, in the Journal of the American Society of Nephrology (JASN).

“Our findings are reflected in current clinical practice guidelines, which promote fistulas as the preferred form of bloodstream access in hemodialysis patients,” said lead author Pietro Ravani, MD, of the University of Calgary, and colleagues. “Better quality data are needed, but not from studies with the same design as those already available. In fact, our cumulative meta-analysis shows that this information was already available 10 years ago.”

An arteriovenous fistula is currently the most recommended access for kidney disease patients who must undergo dialysis, created by connecting a patient's vein and artery to form a long-lasting site through which blood can be removed and returned. Alternatively, in patients who are unsuitable for a fistula, an arteriovenous graft—a plastic conduit between an artery and a vein—may be used. Many patients, however, prefer a catheter, for reasons that include inadequate preparation for dialysis, avoidance of surgery, or fear of needles (since the connection to the dialysis machine via a catheter does not require needles).

Related Links:

University of Calgary
University of Otago



Gold Member
STI Test
Vivalytic Sexually Transmitted Infection (STI) Array
Gold Member
SARS‑CoV‑2/Flu A/Flu B/RSV Sample-To-Answer Test
SARS‑CoV‑2/Flu A/Flu B/RSV Cartridge (CE-IVD)
New
Patient Warming Blanket
Patient Warming Blanket
New
Multi-Parameter Patient Monitor
S90

Print article

Channels

Surgical Techniques

view channel
Image: The Trilogy Valve with locator technology is the only TAVI system approved for aortic regurgitation (Photo courtesy of JenaValve)

New Transcatheter Valve Found Safe and Effective for Treating Aortic Regurgitation

Aortic regurgitation is a condition in which the aortic valve does not close properly, allowing blood to flow backward into the left ventricle. This results in decreased blood flow from the heart to the... Read more

Patient Care

view channel
Image: The portable biosensor platform uses printed electrochemical sensors for the rapid, selective detection of Staphylococcus aureus (Photo courtesy of AIMPLAS)

Portable Biosensor Platform to Reduce Hospital-Acquired Infections

Approximately 4 million patients in the European Union acquire healthcare-associated infections (HAIs) or nosocomial infections each year, with around 37,000 deaths directly resulting from these infections,... Read more