Vascular accesses for hemodialysis in Ceará-Brazil
DOI:
https://doi.org/10.36311/jhgd.v32.13318Keywords:
hemodialysis, double-lumen catheter, vascular accessAbstract
Backgroung: the ideal access for hemodialysis is represented by arteriovenous fistulas both as initial access and in use and are determinants of health care parameters for chronic renal patients.
Objective: to evaluate vascular access for hemodialysis.
Methods: this is a cross-sectional study, with a sample of 2513 individuals on hemodialysis in Ceará. Data were collected on age, sex, time of treatment, underlying disease, initial access and access in use. The data were divided into two groups, the interior of the state and the Metropolitan Region of Fortaleza, in the State of Ceará, and compared using the Student’s Test (p<0.05).
Results: the most common age group was between 19 and 64 years (73%). Men prevailed in both regions, 713 (63%) in the countryside and 792 (57%) in the metropolitan area. The most common cause of Chronic Kidney Disease was Hypertension 306 (27%), followed by Disease of undetermined cause 295 (26%) in the countryside; in the metropolitan region, Diabetes Mellitus 356 (26%) was the main cause, followed by Hypertension and Disease of undetermined cause, each with 344 (25%), p=0.001. In the countryside, 9% started treatment for fistula while in the metropolitan area 12%, p=0.011. 79% of patients in the countryside used fistulas and 81% in the metropolitan area, p=0.156.
Conclusion: arteriovenous fistulas are more frequent as initial accesses in the metropolitan region than in the interior, but there is an equivalence of fistulas in use in both regions. Catheter is the main initial access route. The evaluation of vascular accesses in Ceará showed that hemodialysis services are able to maintain good parameters of care for patients with chronic kidney disease.
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Passos VM, Barreto SM, Lima-Costa MF, et al. Detection of renal dysfunction based on serum creatinine levels in a Brazilian community: the Bambui Health and Ageing Study. Braz J Med Biol Res 2003; 36: 393-401. 2003/03/18.
Sesso RC, Lopes AA, Thome FS, et al. Brazilian Chronic Dialysis Survey 2016. J Bras Nefrol 2017; 39: 261-266. 2017/10/19. DOI: 10.5935/0101-2800.20170049.
Machado GRG PF. Tratamento de diálise em pacientes com Insuficiência Renal Crônica. Cadernos UniFOA 2014; 9.
Rodriguez JA, Armadans L, Ferrer E, et al. The function of permanent vascular access. Nephrol Dial Transplant 2000; 15: 402-408. 2000/02/29.
O’Shaughnessy MM, Montez-Rath ME, Zheng Y, et al. Differences in Initial Hemodialysis Vascular Access Use Among Glomerulonephritis Subtypes in the United States. Am J Kidney Dis 2016; 67: 638-647. 2016/01/18. DOI: 10.1053/j.ajkd.2015.11.019.
Castelbranco O, Soares F and Pinho C. [The role of colour Doppler ultrasound in the creation, maturation and evaluation of arteriovenous fistula for hemodialysis]. Rev Port Cir Cardiotorac Vasc 2012; 19: 31-36. 2012/01/01.
Gunawansa N, Sudusinghe DH and Wijayaratne DR. Hemodialysis Catheter-Related Central Venous Thrombosis: Clinical Approach to Evaluation and Management. Ann Vasc Surg 2018; 51: 298-305. 2018/05/18. DOI: 10.1016/j.avsg.2018.02.033.
Linardi F, Linardi FdF, Bevilacqua JL, et al. Acesso vascular para hemodiálise: avaliação do tipo e local anatômico em 23 unidades de diálise distribuídas em sete estados brasileiros. Revista do Colégio Brasileiro de Cirurgiões 2003; 30: 183-193.
Vascular Access Work G. Clinical practice guidelines for vascular access. Am J Kidney Dis 2006; 48 Suppl 1: S248-273. 2006/07/04. DOI: 10.1053/j.ajkd.2006.04.040.
Burille A and Gerhardt TE. Doenças crônicas, problemas crônicos: encontros e desencontros com os serviços de saúde em itinerários terapêuticos de homens rurais. Saúde e Sociedade 2014; 23: 664-676.
de Medeiros AP, de Menezes Mde F and Napoleao AA. [Risk factors and prevention actions in prostate cancer: fundamentals for nursing]. Rev Bras Enferm 2011; 64: 385-388. 2011/07/15.
Neves Junior MAd, Petnys A, Melo RC, et al. Acesso vascular para hemodiálise: o que há de novo? Jornal Vascular Brasileiro 2013; 12: 221-225.
Marinho AWGB, Penha AdP, Silva MT, et al. Prevalência de doença renal crônica em adultos no Brasil: revisão sistemática da literatura. Cadernos Saúde Coletiva 2017; 25: 379-388.
de Oliveira HM, Jr., Formiga FF and Alexandre Cda S. Clinical and epidemiological profile of chronic hemodialysis patients in Joao Pessoa--PB. J Bras Nefrol 2014; 36: 367-374. 2014/10/16.
Rosa-Diez G, Gonzalez-Bedat M, Pecoits-Filho R, et al. Renal replacement therapy in Latin American end-stage renal disease. Clin Kidney J 2014; 7: 431-436. 2014/10/29. DOI: 10.1093/ckj/sfu039.
Wasse H, Kutner N, Zhang R, et al. Association of initial hemodialysis vascular access with patient-reported health status and quality of life. Clin J Am Soc Nephrol 2007; 2: 708-714. 2007/08/21. DOI: 10.2215/CJN.00170107.
Arnold WP. Improvement in hemodialysis vascular access outcomes in a dedicated access center. Semin Dial 2000; 13: 359-363. 2000/12/29.
Saran R, Robinson B, Abbott KC, et al. US Renal Data System 2016 Annual Data Report: Epidemiology of Kidney Disease in the United States. Am J Kidney Dis 2017; 69: A7-A8. 2017/02/27. DOI: 10.1053/j.ajkd.2016.12.004.
Sequeira A, Naljayan M and Vachharajani TJ. Vascular Access Guidelines: Summary, Rationale, and Controversies. Tech Vasc Interv Radiol 2017; 20: 2-8. 2017/03/11. DOI: 10.1053/j.tvir.2016.11.001.
Silva GM, Gomes IC, Andrade EI, et al. Permanent vascular access in patients with end-stage renal disease, Brazil. Rev Saude Publica 2011; 45: 241-248. 2011/02/24.
Park HS, Lee YH, Kim HW, et al. Usefulness of assisted procedures for arteriovenous fistula maturation without compromising access patency. Hemodial Int 2017; 21: 335-342. 2016/10/08. DOI: 10.1111/hdi.12499.
UK Renal Registry 19th Annual Report (December 2016): Appendix F Additional Data Tables for 2015 new and existing patients. Nephron 2017; 137 Suppl 1: 351-392. 2017/09/21. DOI: 10.1159/000481382.
Polkinghorne KR, Chin GK, MacGinley RJ, et al. KHA-CARI Guideline: vascular access - central venous catheters, arteriovenous fistulae and arteriovenous grafts. Nephrology (Carlton) 2013; 18: 701-705. 2013/07/17. DOI: 10.1111/nep.12132.
Al-Jaishi AA, Lok CE, Garg AX, et al. Vascular access creation before hemodialysis initiation and use: a population-based cohort study. Clin J Am Soc Nephrol 2015; 10: 418-427. 2015/01/09. DOI: 10.2215/CJN.06220614.
Biuckians A, Scott EC, Meier GH, et al. The natural history of autologous fistulas as first-time dialysis access in the KDOQI era. J Vasc Surg 2008; 47: 415-421; discussion 420-411. 2008/02/05. DOI: 10.1016/j.jvs.2007.10.041.
Jemcov T and Dimkovic N. Vascular access registry of Serbia: a 4-year experience. Int Urol Nephrol 2017; 49: 319-324. 2016/07/29. DOI: 10.1007/s11255-016-1378-9.
Shahidi SH and Soheilipour M. Comparison of vascular access use in hemodialysis patients in Isfahan in 2003 and 2013. Indian J Nephrol 2015; 25: 16-20. 2015/02/17. DOI: 10.4103/0971-4065.134656.
Noordzij M, Jager KJ, van der Veer SN, et al. Use of vascular access for haemodialysis in Europe: a report from the ERA-EDTA Registry. Nephrol Dial Transplant 2014; 29: 1956-1964. 2014/07/26. DOI: 10.1093/ndt/gfu253.
Jemcov T, Dimkovic N, Jovanovic D, et al. Erratum to: Vascular access registry of Serbia: a 4-year experience. Int Urol Nephrol 2017; 49: 367. 2017/01/26. DOI: 10.1007/s11255-017-1511-4.
Navuluri R and Regalado S. The KDOQI 2006 Vascular Access Update and Fistula First Program Synopsis. Seminars in interventional radiology 2009; 26: 122-124. DOI: 10.1055/s-0029-1222455.
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