Risk of Vascular Access Complications with Frequent Hemodialysis

• DOI: 10.1681/asn.2012060595
• Publication Date: 2013-02-08T05:55:31Z
• Authors: Rita S. Suri; Brett Larive; Susan Sherer; Paul Eggers; Jennifer Gassman; Sam H. James; Robert M. Lindsay; Robert S. Lockridge; Daniel B. Ornt; Michael V. Rocco; George O. Ting; Alan S. Kliger
• Keywords: Home hemodialysis; Hemodialysis access

Frequent hemodialysis requires using the vascular access more often than with conventional hemodialysis, but whether this increases risk for access-related complications is unknown. In two separate trials, we randomly assigned 245 patients to receive in-center daily (6 days per week) or (3 and 87 home nocturnal nights 12 months. The primary outcome was time first event (repair, loss, hospitalization). Secondary outcomes were all repairs losses. Daily Trial, 77 (31%) of had a event: 33 15 losses in group 17 repairs, 11 losses, 1 hospitalization group. Overall, 76% higher (hazard ratio [HR], 1.76; 95% confidence interval [CI], 1.11–2.79; P=0.017); among 198 an arteriovenous (AV) at randomization, 90% (HR, 1.90; CI, 1.11–3.25; P=0.02). significantly total AV (P=0.011), 55% involving thrombectomy surgical revision. Losses did not differ between groups (P=0.58). We observed similar trends Nocturnal although results statistically significant. conclusion, frequent complications. nature suggests that likely from increased frequency rather heightened surveillance.