| Objective In order to provide clinical basis for selection of vascular access, a comparison was made to evaluate the impact on hospitalization rates and survival between arteriovenous fistula and tunneled cuffed catheter in maintenance hemodialysis patients.Method Patients undergoing maintenance hemodialysis in the First People’s Hospital of Nanning from June 1,2010 to June 1,2014 were included. The clinical data of patients, such as age, gender, primary etiology, times and reasons of hospitalization, clinical outcomes and laboratory parameters, were collected. The hospitalization rate and survival rate were compared between arteriovenous fistula (AVF, n=126) and tunneled cuffed catheter (TCC, n=37). Kaplan-Meier method, log-rank test and Cox regression analysis were used to determine the effect of access type on survival.Result (1)Compared to patients with AVF, those using TCC to hemodialysis had a higher average annual hospitalization rate (P<0.05), with rates of 682 per 1000 person-years and 555 per 1000 person-years, respectively. Cardiovascular and cerebrovascular diseases (30.89%), infection (28.27%) and access-related.events (13.09%) were the leading causes of hospitalization. Compared with patients with AVF, those using TCC had a larger proportion on access-related events (20.72% and 10% respectively, P<0.05).(2) Compared to patients with AVF, those using TCC to hemodialysis had a higher mortality (75 per 1000 person-years and 51 per 1000 person-years respectively, P<0.05). Log-rank test showed that the use of TCC had a worse overall survival compared to patients with AVF (P< 0.05). Cox regression analysis showed that the risk factors for survival in maintenance hemodialysis patients were the use of TCC, diabetes and hypoproteinemia.Conclusion Patients using TCC for maintenance hemodialysis had a higher hospitalization rate and a worse overall survival than those using AVF. The use of TCC was the risk factor for survival in maintenance hemodialysis patients. |
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