Observational studyAmerican journal of kidney diseases : the official journal of the National Kidney Foundation2022
Patient Frailty and Functional Use of Hemodialysis Vascular Access: A Retrospective Study of the US Renal Data System.
Observational study in American journal of kidney diseases : the official journal of the National Kidney Foundation, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.
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Who cites it
12 citing papers in PubMed, 1 synthesis or guideline pooled it, 23 citations in OpenAlex.
- Association between frailty and adverse outcomes in patients undergoing maintenance hemodialysis: a systematic review and meta-analysis.Renal failure · 2024Pooled it
- Risks of arteriovenous fistula failure in hemodialysis patients older than 75 years.Clinical and experimental nephrology · 2026Article
- Comparative outcomes of dialysis vascular access in kidney transplant patients: a propensity score-matched retrospective cohort study.Annals of surgical treatment and research · 2026Article
- Frailty in Focus: A Scoping Review of Frailty Instruments from the Kidney Disease Aging Research Collaborative.Clinical journal of the American Society of Nephrology : CJASN · 2026Article
- Review
- Quality Metrics in Dialysis: A Welcome Change for Vascular Access.Advances in kidney disease and health · 2025Review
- Pausing before Surgery Referral in Patients with ESKD on Hemodialysis to Ensure Patient-Centered Care.Kidney360 · 2025Article
- Associations between initial dialysis access types and death from dialysis withdrawal in incident patients with kidney failure.Clinical kidney journal · 2025Article
- Frailty in Kidney Disease: A Comprehensive Review to Advance Its Clinical and Research Applications.American journal of kidney diseases : the official journal of the National Kidney Foundation · 2025Review
- A decade of arteriovenous fistula creations in the ⩾75 years population: Equal opportunity or sub-optimal use of resources.The journal of vascular access · 2024Article
- Barriers to Implementing the Kidney Disease Outcomes Quality Initiative End-Stage Kidney Disease Life Plan Guideline.Journal of general internal medicine · 2023Article
- Depression is associated with frailty and lower quality of life in haemodialysis recipients, but not with mortality or hospitalization.Clinical kidney journal · 2023Article
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Authors and funding
4 authors at 2 institutions in 1 country.
Funding
Abstract
RATIONALE &
objectiveDespite the high prevalence of frailty among dialysis patients, it is unknown whether frailty is associated with dialysis vascular access failure. This study examined the association between frailty and functional use of vascular access. STUDY
designRetrospective observational study. SETTING &
participantsPatients who initiated hemodialysis through a tunneled catheter in the US Renal Data System database from 2012 through 2017 and underwent subsequent creation of an arteriovenous fistula or graft. PREDICTORS: The "claims-based frailty indicator" (CFI) was calculated using a validated claims-based disability status model anchored to a well-described frailty phenotype. OUTCOMES: Time to functional use for fistulas and grafts defined as the time from initiation of hemodialysis to treatments using the index vascular access with 2 needles. ANALYTICAL APPROACH: Fine and Gray competing risk models separately examining fistula and graft outcomes. Patient survival was modeled for the entire cohort using Cox proportional hazards regression.
resultsA total of 41,471 patients met inclusion criteria, including 33,212 who underwent fistula creation and 8,259 who underwent graft placement. Higher CFI quartiles were associated with a greater rate of mortality. Patients in the highest CFI quartile had more than 2 times the rate of mortality compared with patients in the lowest CFI quartile (hazard ratio [HR], 2.49 [95% CI, 2.41-2.58]). In multivariable analyses, the highest CFI quartile was significantly associated with longer time to functional use of fistulas (HR, 0.65 [95% CI, 0.62-0.69]) and grafts (HR, 0.88 [95% CI, 0.79-0.98]). LIMITATIONS: Generalizability may be limited by the requirement of 12 months of Medicare claims availability before initiation of dialysis. There were no data on patient anatomic characteristics or surgeon characteristics and limited patient-specific sociodemographic data.
conclusionsHigher degrees of frailty are associated with longer times to vascular access functional use. Frailty may be useful for informing clinical decision-making regarding choice of vascular access.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.