Evidence map›Paper›PMID 39225811›Full record

ArticlePediatric nephrology (Berlin, Germany)2025

Establishing an autogenous vascular access program in a Guatemalan comprehensive pediatric nephrology center.

William C Jennings, Ana Leslie Galvez, Nasir Mushtaq, Raúl Ernesto Sosa Tejada, Alexandros Mallios, John F Lucas, Mark Randel, Randall Lou-Meda

Abstract read
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Article in Pediatric nephrology (Berlin, Germany), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Little kidneys amid large global inequities.Pediatric nephrology (Berlin, Germany) · 2026
    Review
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

William C JenningsDivision of Vascular Surgery, Department of Surgery, School of Community Medicine, University of Oklahoma, 1919 S. Wheeling Avenue, Suite 600, Tulsa, OK, 74104, USA. william-jennings@outlook.com.ORCID http://orcid.org/0000-0003-3599-0609
Ana Leslie GalvezServicio de Nefrología, Hipertensión, Diálisis y Trasplante, Departamento de Pediatría, Hospital Roosevelt/FUNDANIER, Guatemala City, Guatemala.
Nasir MushtaqDepartment of Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center, 4502 E. 41St Street, SAC 1A02, Tulsa, OK, 74135, USA.
Raúl Ernesto Sosa TejadaDepartment of Pediatric Surgery, Hospital Roosevelt, Mariano Galvez University, Guatemala City, Guatemala.
Alexandros MalliosService de Chir Vasc, Groupe Hospitalier Paris Saint Joseph, 185 Rue Raymond Losserand, 75014, Paris, France.
John F LucasDepartment of Surgery, Greenwood Leflore Hospital, 1401 River Road, Greenwood, MS, 38930, USA.
Mark RandelDepartment of Surgery, Jack C. Montgomery Department of Veterans Affairs Medical Center, 1011 Honor Heights Drive, Muskogee, OK, 74401-1318, USA.
Randall Lou-MedaServicio de Nefrología, Hipertensión, Diálisis y Trasplante, Departamento de Pediatría, Hospital Roosevelt/FUNDANIER, Guatemala City, Guatemala.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe Guatemalan Foundation for Children with Kidney Diseases collaborated with Bridge of Life, a not-for-profit charitable organization, to establish a vascular access program. We reviewed our experience with graded surgical responsibility and structured didactic training, creating arteriovenous fistulas (AVF) for Guatemalan children.

methodsPediatric vascular access missions were completed from 2015 to 2023 and analyzed retrospectively. Follow-up was completed by the Guatemalan pediatric surgeons, nephrologists, and nursing staff. AVF patency and patient survival were evaluated by Kaplan-Meier life-table analysis with univariate and multivariable association between patient demographic variables by Cox proportional hazards models.

resultsAmong a total of 153 vascular access operations, there were 139 new patient procedures, forming the study group for this review. The mean age was 13.6 years, 42.6% were female, and the mean BMI was 17.3. Radial or ulnar artery-based direct AVFs were established in 100 patients (71.9%) and ten of the 25 transposition procedures. Brachial artery inflow was required in 29 direct AVFs (20.9%). Two patients underwent femoral vein transpositions. Access-related distal ischemia was not encountered. Seven of the AVF patients later required access banding for arm edema; all had previous dialysis catheters (mean = 9, range 4-12). Primary and cumulative patency rates were 84% and 86% at 12 months and 64% and 81% at 24 months, respectively. The median follow-up was 12 months. Overall patient survival was 84% and 67% at 12 and 24 months, respectively. There were no deaths related to AVF access.

conclusionsSafe and functional AVFs were established in a teaching environment within a Guatemalan comprehensive pediatric nephrology center.

Indexed as

Arteriovenous Shunt, SurgicalNephrologyRenal DialysisAdolescentChildChild, PreschoolFemaleGuatemalaHumansInfantKidney Failure, ChronicMaleRetrospective StudiesVascular PatencyAdolescentsArteriovenous fistulaAutogenousAVFChildrenChronic kidney diseaseChronic renal failureGuatemalaHemodialysisKidney failureMedical missionPediatricVascular 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.