PTFE Grafts Versus Tunneled Cuffed Catheters for Hemodialysis: Which Is the Second Choice When Arteriovenous Fistula Is Not Feasible?
PTFE Grafts Versus Tunneled Cuffed Catheters for Hemodialysis: Which Is the Second Choice When Arteriovenous Fistula Is Not Feasible?
复制标题
DOI：
10.1111/aor.12353
复制
发表时间：
2015-02-01
影响因子：
2.4
通讯作者：
Stefoni, Sergio
中科院分区：
文献类型：
--
作者：
Donati, Gabriele;Cianciolo, Giuseppe;Stefoni, Sergio
血管通路相关并发症仍然是血液透析患者发病率的主要原因之一。本研究的目的是比较聚四氟乙烯(PTFE)和隧道袖带永久性导管(TCC)在血管通路和患者存活率方面的差异。进行了一项观察性研究，并进行了2年的随访。87名慢性血液透析患者入选：31名使用聚四氟乙烯作为血液透析的血管通路，56名使用TCC。患者的平均年龄(移植物)为63.8±14.6岁，而移植物为73.5±11.3岁(TCC)，P=0.001。TCC患者房颤发生率(30.3%)明显高于移植物患者(6.5%，P=0.01)。在未调整的Kaplan-Meier分析中，移植物移植物24个月的中位生存期比PTFE移植物多5.4个月，但差异无统计学意义(对数等级检验=1.3，P=ns)。在对年龄、性别、既往血管通路数、糖尿病、房颤、吸烟和任何并发症进行校正的COX回归分析中，证实了TCC组和PTFE组血管通路存活率无显著差异，糖尿病是两组血管通路存活率的独立危险因素(P=0.02)。在未调整的Kaplan-Meier分析中，24个月时TCC组的死亡率高于PTFE组(LOG-RANK检验=10.07，P
Vascular access-related complications are still one of the leading causes of morbidity in hemodialysis patients. The aim of this study was to compare polytetrafluoroethylene (PTFE) grafts versus tunneled cuffed permanent catheters (TCCs) in terms of vascular access and patients' survival. An observational study was carried out with a 2-year follow-up. Eighty-seven chronic hemodialysis patients were enrolled: 31 with a PTFE graft as vascular access for hemodialysis versus 56 with a TCC. Patients' mean age was 63.8 +/- 14.6 (grafts) versus 73.5 +/- 11.3 years (TCCs), P=0.001. Significantly more patients with TCC had atrial fibrillation than patients with grafts (30.3% versus 6.5%, P=0.01). In an unadjusted Kaplan-Meier analysis, median TCC survival at 24 months was 5.4 months longer than that of PTFE grafts but not significantly (log-rank test=1.3, P=ns). In a Cox regression analysis adjusted for age, gender, number of previous vascular accesses, diabetes, atrial fibrillation, smoking, and any complication, this lack of significant difference in survival of the vascular access between TCC and PTFE groups was confirmed and diabetes proved to be an independent risk factor for the survival of both vascular accesses considered (P=0.02). In an unadjusted Kaplan-Meier analysis, a higher mortality was found in the TCC group than in the PTFE group at 24 months (log-rank test=10.07, P