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Research Article
Patient Characteristics Predict Patency of Early-Cannulation Arteriovenous Grafts
David Kingsmore
Queen Elizabeth University Hospital, Glasgow, United Kingdom
Corresponding Author
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This work is licensed under a CC BY 4.0 License. Read Full License
There is a new emphasis on tailoring appropriate vascular access for hemodialysis to patients and their life-plans, but there is little known about the optimal use of newer devices such as early-cannulation arteriovenous grafts (ecAVG), with studies utilising them in a wide variety of situations. The aim of this study was to determine if the outcome of ecAVG can be predicted by patient characteristics known pre-operatively. This retrospective analysis of 278 consecutive ecAVG with minimum one-year follow-up correlated functional patency with demographic data, renal history, renal replacement and vascular access history.
On univariate analysis, aetiology of renal disease, indication for an ecAVG, the number of previous tunnelled central venous catheters (TCVC) prior to insertion of an ecAVG, peripheral vascular disease, and BMI were significant associates with functional patency. On multivariate analysis the number of previous TCVC, the presence of peripheral vascular disease and indication were independently associated with outcome after allowing for age, sex and BMI.
When selecting for vascular access, understanding the clinical circumstances such as indication and previous vascular access can identify patients with differing outcomes. Importantly strategies that result in TCVC exposure have an independent and cumulative association with decreasing long-term patency for subsequent ecAVG. As such, TCVC exposure is best avoided or minimised particularly when ecAVG can be considered.
Keywords
early-cannulation arteriovenous grafts (ecAVG), tunnelled central venous catheters (TCVC)
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CURRENT STATUS: Under Review
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Posted 22 Dec, 2020
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Review #2 received
Received 20 Jan, 2021
Review #3 received
Received 20 Jan, 2021
Review #1 received
Received 20 Jan, 2021
Reviewer #5 agreed
On 18 Jan, 2021
Reviewer #2 agreed
On 18 Jan, 2021
Reviewer #3 agreed
On 18 Jan, 2021
Reviewer #6 agreed
On 18 Jan, 2021
Reviewer #1 agreed
On 18 Jan, 2021
Reviewer #4 agreed
On 18 Jan, 2021
Reviewers invited
Invitations sent on 18 Jan, 2021
Editor assigned
On 18 Jan, 2021
Editor invited
On 22 Dec, 2020
Submission checks complete
On 21 Dec, 2020
First submitted
On 03 Dec, 2020
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Subject Areas
Urology & Nephrology
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This preprint is under consideration at Scientific Reports. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research Article
Patient Characteristics Predict Patency of Early-Cannulation Arteriovenous Grafts
David Kingsmore
Queen Elizabeth University Hospital, Glasgow, United Kingdom
Corresponding Author
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Review
Version 1
Posted 22 Dec, 2020
No community comments so far
Review #2 received
Received 20 Jan, 2021
Review #3 received
Received 20 Jan, 2021
Review #1 received
Received 20 Jan, 2021
Reviewer #5 agreed
On 18 Jan, 2021
Reviewer #2 agreed
On 18 Jan, 2021
Reviewer #3 agreed
On 18 Jan, 2021
Reviewer #6 agreed
On 18 Jan, 2021
Reviewer #1 agreed
On 18 Jan, 2021
Reviewer #4 agreed
On 18 Jan, 2021
Reviewers invited
Invitations sent on 18 Jan, 2021
Editor assigned
On 18 Jan, 2021
Editor invited
On 22 Dec, 2020
Submission checks complete
On 21 Dec, 2020
First submitted
On 03 Dec, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Urology & Nephrology
License:
This work is licensed under a CC BY 4.0 License. Read Full License
There is a new emphasis on tailoring appropriate vascular access for hemodialysis to patients and their life-plans, but there is little known about the optimal use of newer devices such as early-cannulation arteriovenous grafts (ecAVG), with studies utilising them in a wide variety of situations. The aim of this study was to determine if the outcome of ecAVG can be predicted by patient characteristics known pre-operatively. This retrospective analysis of 278 consecutive ecAVG with minimum one-year follow-up correlated functional patency with demographic data, renal history, renal replacement and vascular access history.
On univariate analysis, aetiology of renal disease, indication for an ecAVG, the number of previous tunnelled central venous catheters (TCVC) prior to insertion of an ecAVG, peripheral vascular disease, and BMI were significant associates with functional patency. On multivariate analysis the number of previous TCVC, the presence of peripheral vascular disease and indication were independently associated with outcome after allowing for age, sex and BMI.
When selecting for vascular access, understanding the clinical circumstances such as indication and previous vascular access can identify patients with differing outcomes. Importantly strategies that result in TCVC exposure have an independent and cumulative association with decreasing long-term patency for subsequent ecAVG. As such, TCVC exposure is best avoided or minimised particularly when ecAVG can be considered.
Figure 1
Figure 2