Preferred Haemodialysis Vascular Access for Diabetic Chronic Kidney Disease Patients: A Systematic Literature Review

Author:

Coentrão Luís1,Van Biesen Wim23,Nistor Inout34,Tordoir Jan5,Gallieni Maurizio6,Marti Monros Anna7,Bolignano Davide38

Affiliation:

1. Nephrology and Infectious Diseases Research and Development Group, INEB-(I3S), University of Porto, Porto - Portugal

2. Renal Division, Ghent University Hospital, Ghent - Belgium

3. Methods Support Team European Renal Best Practice, Ghent University Hospital, Ghent - Belgium

4. Nephrology Department, Gr. T. Popa University of Medicine and Pharmacy, Lasi - Romania

5. Department of Surgery, Maastricht University, Maastricht - The Netherlands

6. Nephrology and Dialysis Unit, Ospedale San Carlo Borromeo, Department of Biomedical and Clinical Sciences ‘L. Sacco’, University of Milan, Milan - Italy

7. Nephrology Department, Consorcio Hospital General, Valencia - Spain

8. CNR- Institute of Clinical Physiology, Reggio Calabria - Italy

Abstract

Background Vascular access problems are one of the main concerns in the diabetic end-stage kidney disease (ESKD) population. However, the optimal strategy for the establishment of vascular access in this population remains to be solved. We performed a systematic review in order to clarify the most advisable approach of vascular access planning in diabetic patients with ESKD. Methods MEDLINE, EMBASE and CENTRAL databases were searched for English-language articles without time restriction through focused, high-sensitive search strategies. We included all studies providing outcome data on diabetics starting chronic haemodialysis treatment on the basis of the type of primary placed vascular access. Results A total of 13 studies comprising over 2,800 participants with diabetes were reviewed in detail and included in the review. We found that diabetic patients using a dialysis catheter apparently experience a higher risk of death and infection compared with patients who successfully achieved and maintained an arteriovenous fistula as dialysis access. The comparison between the use of a graft or an autogenous fistula as dialysis access generated conflicting results. Primary patency rates appeared to be lower in diabetics versus non-diabetics. Conclusions Our study suggests that diabetic ESKD patients with dialysis catheters incur a higher risk of death in comparison to those who achieve an arteriovenous access. It is however unclear whether this is caused by residual selection bias or by a true advantage of native vascular access.

Publisher

SAGE Publications

Subject

Nephrology,Surgery

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3