Features | Partner Sites | Information | LinkXpress
Sign In
VIEWORKS
Advantech Europe
Schiller

Catheters in Dialysis Linked to High Risk of Infection

By HospiMedica International staff writers
Posted on 04 Mar 2013
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




Channels

Surgical Techniques

view channel

Restricting Transfusions After Cardiac Surgery Shows No Benefit

A new study concludes that there is no health advantage if doctors wait until a heart surgery patient becomes substantially anemic before receiving a transfusion. Researchers at the University of Leicester (United Kingdom), Bristol Royal Infirmary (BRI; United Kingdom), and other institutions conducted a multicenter,... Read more

Women's Health

view channel

Women Undergoing Heart Attack Delay Hospital Arrival

Women suffering a heart attack wait much longer than men to call emergency medical services and face significantly longer delays getting to a hospital, according to a new study. Researchers at the University of Bologna (Italy) examined records of 7,457 European patients enrolled from 2010 to 2014 in an international... Read more

Health IT

view channel
Image: ResolutionMD across multiple devices (Photo courtesy of Calgary Scientific).

Healthcare Communication Platform Offers Seamless Image Access

Novel diagnostic medical imaging software offers better access to health information, supports increased teamwork, and enhances communication among practitioners and patients. ResolutionMD enables doctors... Read more

Business

view channel
Image: An Air Evac Lifeteam Bell 206 Long Ranger helicopter (Photo courtesy Air Evac Lifeteam).

KKR Seals Deal to Buy Air Medical Group for USD 2 Billion

KKR (New York, NY, USA) have agreed to acquire Air Medical Group Holdings (AMGH; Lewisville, TX, USA), a leading provider of air ambulance services, in a deal valued at USD two billion, including debt.... Read more
 
Copyright © 2000-2015 Globetech Media. All rights reserved.