Fistula-first and catheter-last: fading certainties and growing doubts

Authors:
Open Access
Publisher website
Google Scholar
Abstract
In this issue of Nephrology Dialysis and Transplantation, Grubbs et al. [1] present USRDS data on the association between vascular access type at hemodialysis initiation and 6-month mortality in 117 277 patients who started hemodialysis therapy between January 2005 and December 2007. Thanks to additional access information included in the End-Stage Renal Disease Medical Evidence Report (form CMS-2728) since 2005 [2], the authors were able to classify the initial hemodialysis access as either fistula alone, graft alone, catheter with maturing fistula, catheter with maturing graft or catheter alone. The authors found that, compared with people using a fistula, the risk of death from all causes was progressively higher in people using grafts, in those using catheters with a maturing fistula, in those using catheters with a maturing graft and in those using catheter without a maturing arteriovenous access. Six-month mortality data were similar to long-term results from a previous analysis of USRDS data [3].

This publication has 20 references indexed in Scilit: