Comparative outcomes of arteriovenous accesses with and without tunneled hemodialysis catheters: A retrospective cohort study.
4 affiliations
- 1Division of Cardiovascular Surgery, Department of Surgery, E-DA hospital and College of Medicine, I-Shou University, Kaohsiung, Taiwan.
- 2Division of General Surgery, E-Da Hospital, Kaohsiung, Taiwan.
- 3Department of Surgery, Bariatric and Metabolism International Surgery Center, E-Da Hospital, Kaohsiung, Taiwan.
- 4School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan.
Abstract
This study compared patency rates of arteriovenous accesses with and without concurrent tunneled hemodialysis catheter (THC) use, addressing limited research on combined outcomes. A retrospective cohort analysis was conducted on patients undergoing arteriovenous access creation at a single hospital between January 2021 and December 2022. Primary outcomes were the 6-month primary patency rate and functional dialysis success. Secondary outcomes were the factors associated with each of these endpoints. Statistical analyses employed t tests, chi-square tests, logistic regression, and Kaplan-Meier survival curves. A total of 319 vascular accesses were included. The 6-month patency rate was significantly higher in the access-only group than in the access + THC group (87.04% vs 78.20%, P = .04). THC usage (odds ratio [OR] = 0.49, 95% confidence interval [CI]: 0.25-0.95, P = .03), graft usage (OR = 0.38, 95% CI: 0.18-0.82, P = .01), and higher hemoglobin levels (OR = 0.80, 95% CI: 0.65-0.96, P = .02) were associated with reduced patency rates. Functional dialysis success at 6 months did not differ significantly between groups (87.96% vs 83.89%, P = .21). However, older age (OR = 0.96, 95% CI: 0.93-0.99, P = .01), use of a cubital artery to an autologous vein (OR = 0.39, 95% CI: 0.19-0.82, P = .01) or graft (OR = 0.40, 95% CI: 0.17-0.97, P = .04), and higher hemoglobin levels (OR = 0.81, 95% CI: 0.66-0.99, P = .03) were associated with a lower likelihood of functional dialysis success. Concurrent THC use was independently associated with reduced 6-month primary patency without a corresponding reduction in the short-term delivery of dialysis, suggesting an increased need for interventions to maintain the access. Judicious use of THCs and careful consideration of the vascular access type are important to optimize vascular access outcomes in patients undergoing hemodialysis.
Related
- Cross-elbow stent placement for refractory arteriovenous fistula stenosis and chronic total occlusion in hemodialysis patients: a single-center retrospective cohort of 42 cases
- Progress on the related mechanisms of vascular calcification in autogenous arteriovenous fistula in hemodialysis patients
- Ultrasound-guided angioplasty of arteriovenous fistula for hemodialysis: initial experience of a single center
- Current status of pharmacological interventions for preventing stenosis of arteriovenous hemodialysis access
- Hydraulic performance of 14-G hemodialysis catheters versus an 8-Fr arterial cannula in a mock 3-kg small-dog cardiopulmonary bypass circuit
BibTeX
@article{su2026comparative,
title = {{Comparative outcomes of arteriovenous accesses with and without tunneled hemodialysis catheters: A retrospective cohort study.}},
author = {Heng Su and Heng Su and Ting-Wei Lin and Ting-Wei Lin and Jian-Han Chen and Hsuan-Yin Wu},
journal = {Medicine},
year = {2026},
month = oct,
doi = {10.1097/md.0000000000051077},
url = {https://europepmc.org/article/MED/42888632},
note = {CC BY},
}
RIS
TY - JOUR
TI - Comparative outcomes of arteriovenous accesses with and without tunneled hemodialysis catheters: A retrospective cohort study.
AU - Heng Su
AU - Heng Su
AU - Ting-Wei Lin
AU - Ting-Wei Lin
AU - Jian-Han Chen
AU - Hsuan-Yin Wu
PY - 2026
DA - 2026/10/01
JO - Medicine
DO - 10.1097/md.0000000000051077
UR - https://europepmc.org/article/MED/42888632
AB - This study compared patency rates of arteriovenous accesses with and without concurrent tunneled hemodialysis catheter (THC) use, addressing limited research on combined outcomes. A retrospective cohort analysis was conducted on patients undergoing arteriovenous access creation at a single hospital between January 2021 and December 2022. Primary outcomes were the 6-month primary patency rate and functional dialysis success. Secondary outcomes were the factors associated with each of these endpoints. Statistical analyses employed t tests, chi-square tests, logistic regression, and Kaplan-Meier survival curves. A total of 319 vascular accesses were included. The 6-month patency rate was significantly higher in the access-only group than in the access + THC group (87.04% vs 78.20%, P = .04). THC usage (odds ratio [OR] = 0.49, 95% confidence interval [CI]: 0.25-0.95, P = .03), graft usage (OR = 0.38, 95% CI: 0.18-0.82, P = .01), and higher hemoglobin levels (OR = 0.80, 95% CI: 0.65-0.96, P = .02) were associated with reduced patency rates. Functional dialysis success at 6 months did not differ significantly between groups (87.96% vs 83.89%, P = .21). However, older age (OR = 0.96, 95% CI: 0.93-0.99, P = .01), use of a cubital artery to an autologous vein (OR = 0.39, 95% CI: 0.19-0.82, P = .01) or graft (OR = 0.40, 95% CI: 0.17-0.97, P = .04), and higher hemoglobin levels (OR = 0.81, 95% CI: 0.66-0.99, P = .03) were associated with a lower likelihood of functional dialysis success. Concurrent THC use was independently associated with reduced 6-month primary patency without a corresponding reduction in the short-term delivery of dialysis, suggesting an increased need for interventions to maintain the access. Judicious use of THCs and careful consideration of the vascular access type are important to optimize vascular access outcomes in patients undergoing hemodialysis.
SN - 0304-5412
SN - 1536-5964
ER -