Late acceleration of glomerular filtration rate decline is a risk for hemodialysis catheter use in patients with established nephrology chronic kidney disease care

摘要: Chronic kidney disease (CKD) patients with established nephrology care have a high rate of tunneled dialysis catheters (TDC) as first vascular access when transitioning to hemodialysis (HD). We sought identify factors associated this problem. Patients who started HD and had prior CKD within our renal clinic were categorized according type at incident HD. Clinical factors, all estimated glomerular filtration rates (eGFR), attendance records, hospital admissions in the 6 months preceding start, patient participation predialysis education course analyzed. Three hundred thirty-eight initiated HD, 107 received pre-HD clinics. Seventy TDC. All groups similar eGFR values. The trajectory decline start was significantly more rapid TDC group. group acute health events months. Multivariate modeling showed that failure attend having initiation both use. less likely attended course. This appears correspond observed increased number emergency visits end-stage disease.