Factors affecting fistula failure in patients on chronic hemodialysis: a population- based case-control study

doi:10.1186/s12882-018-1010-6

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Title:	Factors affecting fistula failure in patients on chronic hemodialysis: a population- based case-control study
Authors:	Yen, Cheng-Chieh Tsai, Ching-Fang Luo, Yueh-Yun Yang, Hsin-Yi Liu, Mei-Yin Hung, Peir-Haur Hsu, Yueh-Han
Contributors:	Chia Yi Christian Hosp, Ditmans Med Fdn, Dept Internal Med, Div Nephrol Chia Yi Christian Hosp, Ditmans Med Fdn, Dept Med Res Chia Yi Christian Hosp, Ditmans Med Fdn, Dept Nursing Hlth Ctr Houbi Dist Chia Nan Univ Pharm & Sci, Dept Appl Life Sci & Hlth China Med Univ, China Med Univ Hosp, Dept Med Res Min Hwei Coll Hlth Care Management, Dept Nursing
Keywords:	Diabetes mellitus Dialysis frequency Dialysis provider level Fistula care Hemodialysis Late fistula failure Quality improvement Taiwan
Date:	2018-08-22
Issue Date:	2019-11-15 15:43:38 (UTC+8)
Publisher:	BMC
Abstract:	Background: With advancement of hemodialysis (HD) technique, late fistula failure (LFF) remains a problem significantly affecting life quality of patients. We attempt to identify factors affecting LFF in patients on chronic HD in Taiwan from the National Health Insurance Research Database. Methods: This case-control study enrolled patients over 18 years old and who received regular HD for more than 3 months. LFF was defined as the first fistula failure episode beyond 3 months of chronic HD. We analyzed characteristics, comorbidities and medicine and investigated the association factors of LFF by logistic regression model. A trend test was conducted for risk in different provider levels. Sensitivity tests were conducted to test consistency. Results: Of 1558 patients recruited, 772 (49.6%) were identified as LFF cases and 786 were identified as controls. The data showed that patients with diabetes mellitus (DM) had 42% increased rate of LFF. Patients receiving more than 10 HD sessions per month had a 90% increased rate of LEE; patients receiving chronic HD in private clinics had a 49% reduction rate of LFF. There were no significant differences in age, dialysis frequency, and comorbidities among different provider levels. There was a significant trend of risk reduction of the event from medical centers, regional hospitals, district hospitals, to private clinics. The sensitivity tests revealed similar results. Conclusions: The factors associated with LFF include DM and receiving more HD sessions; on the contrary, receiving HD in private clinics is associated with less risk of LFF.
???metadata.dc.relation.uri???:	http://dx.doi.org/10.1186/s12882-018-1010-6
Relation:	Bmc Nephrology, v.19, 213
Appears in Collections:	[Dept. of Life and Health Science] Periodical Articles

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