SynthesisBMC geriatrics2025
A meta-analysis of the impact of initial hemodialysis access type on mortality in elderly incident hemodialysis population.
Synthesis in BMC geriatrics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
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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.
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Who cites it
2 citing papers in PubMed.
- Predictors of one-year mortality in hemodialysis patients with end-stage renal disease at a Kenyan county hospital.World journal of nephrology · 2026Article
- Epidemiology of Vascular Access in Patients Undergoing Chronic Hemodialysis Treatment in Greece.Journal of clinical medicine · 2025Article
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundSelecting the appropriate vascular access type for elderly patients before initiating hemodialysis presents a challenge, given their limited life expectancy and multiple comorbidities. This systematic review aims to evaluate whether initial arteriovenous access (AVa), including arteriovenous fistulas (AVF) and/or arteriovenous grafts (AVG), offers a benefit in reducing the risk of all-cause mortality compared to central venous catheters (CVC) for patients aged ≥ 65 years.
methodsWe conducted searches in PubMed (from 1946 to March 20, 2023), Embase (from 1947 to 20 March 20, 2023), and the Cochrane Library to identify studies comparing the use of CVC with AVa as the initial vascular access in hemodialysis patients aged ≥ 65 years. The primary outcome of interest was all-cause mortality. We pooled the hazard ratio (HR) and 95% confidence intervals (CIs) of the included studies using a random-effect model. The Newcastle-Ottawa Scale was employed to assess the risk of bias for each included study.
resultsTen studies involving over 300,000 patients were included, all of which were retrospective cohort studies. Compared to AVa, the use of CVC as the initial dialysis access is associated with a higher incidence of all-cause mortality in patients aged ≥ 65 years (HR = 1.53, 95%CI = 1.41-1.67, I
conclusionIn this analysis, we observed an increased risk of death in elderly patients initiating dialysis with CVC compared to those using AVa. However, the retrospective cohort studies included in this analysis are susceptible to selection bias, indicating that further randomized controlled trials are necessary to confirm these findings.
fundingThis systematic review and meta-analysis were not funded. REGISTRATION: The protocol of this systematic review has been registered in the PROSPERO registry (CRD42023435577; https://www.crd.york.ac.uk/prospero ).
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