Use Of Catheters In Dialysis Linked With High Risk Of Infections, Heart Problems, And DeathMain Category: Urology / Nephrology
Also Included In: Cardiovascular / Cardiology | Infectious Diseases / Bacteria / Viruses | Blood / Hematology
Article Date: 25 Feb 2013
Review examines safety of different dialysis procedures to access the blood
For kidney disease patients who must undergo dialysis, experts recommend an arteriovenous fistula, which is created by connecting patient's own vein and artery to form a long-lasting site through which blood can be removed and returned. Alternatively, a patient may use an arteriovenous graft, which is a plastic conduit between an artery and a vein. Many patients use a catheter instead for several reasons, including inadequate preparation for dialysis, avoidance of surgery or fear of needles, as attachment to the dialysis machine via a catheter does not require needles. Also, an arteriovenous fistula or graft is not possible in all patients, especially those who are sicker.
To compare different types of vascular access for dialysis, Pietro Ravani, MD, PhD (University of Calgary, Canada) and his colleagues reviewed the medical literature, evaluating the associations between arteriovenous fistula, arteriovenous graft, and central venous catheter with risk for death, infection, and major heart-related events such as heart attacks and strokes. The researchers identified 67 studies comprising 586,337 participants.
Among the major findings:
"Our findings are reflected in current clinical practice guidelines, which promote fistulas as the preferred form of bloodstream access in hemodialysis patients, said Dr. Ravani. He added that the studies they identified were of low quality, though. "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," he explained.
Original article posted on Medical News Today.
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