Access Type as A Predictor of Dialysis Dose and Efficiency in Hemodialysis Patients.
- Author:
Jung Hyun LIM
1
;
Seung Won CHOI
;
Jong Joon AHN
;
Jong Ha PARK
;
Hyun Chul CHUNG
;
Sang Hun SHIN
;
Ji Ho LEE
;
Jong Su LEE
Author Information
1. Department of Internal Medicine, College of Medicine, Ulsan University, Ulsan, Korea. hcjungmd@uuh.ulsan.kr
- Publication Type:Original Article
- Keywords:
Adequacy;
Catheter;
Arteriovenous fistula;
Hemodilaysis
- MeSH:
Arteriovenous Fistula;
Catheterization;
Catheters;
Demography;
Dialysis*;
Humans;
Jugular Veins;
Male;
Mortality;
Prescriptions;
Renal Dialysis*
- From:Korean Journal of Nephrology
2006;25(4):587-593
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: Use of venous catheter is associated with increased mortality in hemodialysis patients, but little data are available on impact of vascular access type on the discrepancy between dialysis prescription and dose. Dialysis prescription commonly exceeds the delivered dialysis dose. The purpose of this study are to evaluate the dialysis dose and efficiency between a tunneled cuffed catheters (TCCs) and arteriovenous fistulas (AVF) to the same patients on different dialysis days. METHODS: This study enrolled 35 hemodialysis patients. All patients started dialysis via tunneled cuffed catheters (Permcath(R)) in the internal jugular vein and a vascular surgeon created AVF later. We investigated prescribed spKT/V (pKt/V) and delivered spKt/V (dKt/V) within 2 months after the TCCs placement and after the AVF cannulation. Dialysis efficiencies (dKt/V/pKt/V) were compared over this two distinct times. RESULTS: Patient demographics were similar between two distinct times. The mean age of patients was 52.7 years (18 men, 17 women) and mean BMI was 21.9. 17 patients (48.6%) were diabetics. The mean pKt/V was not different (TCCs 1.63+/-0.30; AVF 1.62+/-0.29) but mean dKt/V was significantly different (TCCs 1.38+/-0.31; AVF 1.46+/-0.34) (p<0.05). The dialysis efficiencies were 85.14% for TCCs and 90.74% for AVF (p<0.05). There were no differences in sex, or diabetics. Underdialysis (delivered spKt/V <1.3) was greater in TCCs (17/35; 48.6 %), compared to AVF (10/35; 28.6%). Underdialysis was more common in larger patients. CONCLUSION: Our data suggest that AVF tend to receive more dialysis dose than tunneled cuffed catheters and underdialysis exposure are more common with catheter use.
