VASCULAR ACCESS USE IN EUROPE AND THE UNITED STATES: RESULTS FROM THE DOPPS

作者: Ronald L. Pisoni , Eric W. Young , Dawn M. Dykstra , Roger N. Greenwood , Erwin Hecking

DOI: 10.1046/J.1523-1755.2002.00117.X

关键词:

摘要: Vascular access use in Europe and the United States: Results from DOPPS. Background A direct broad-based comparison of vascular survival (EUR) States (US) has not been performed previously. Case series reports suggest that practices differ substantially US EUR. We report on a representative study (DOPPS) which used same data collection protocol for> 6400 hemodialysis (HD) patients to compare at 145 dialysis units 101 five EUR countries (France, Germany, Italy, Spain, Kingdom). Methods Logistic analysis evaluated factors associated with native arteriovenous fistula (AVF) versus graft or permanent catheter for prevalent incident HD patients. Times failure AVF were analyzed using Cox proportional hazards regression. was by 80% 24% patients, significantly younger age, male gender, lower body mass index, non-diabetic status, lack peripheral disease, no angina. After adjusting these factors, still much higher than (AOR = 21, P 30 days prior ESRD compared 74% ( 0.01). New had 1.8-fold greater odds 0.002) starting if facility's typical time referral placement ≤2 weeks. when grafts 0.61, 0.04) surgery trainees assisted placements. When as patient's first access, superior regarding (RR 0.53, 0.0002), longer 0.49, 0.0005). each displayed better initiating being after began catheter. Conclusion Large differences exist between US, even adjustment patient characteristics. The results strongly preferences approaches practice are major determinants use.

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