ArticleJournal of nephrology2025
Exploring vascular access survival in prevalent thrice-weekly in-centre nocturnal haemodialysis patients.
Article in Journal of nephrology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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7 authors.
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Abstract
backgroundThis study explores vascular access complications in patients established on in-centre nocturnal haemodialysis (INHD) compared to conventional haemodialysis.
methodsThis was a retrospective cohort study; patients acted as their own control. Data were collected from three centres. Adults established on INHD (intervention) preceded by usual daytime haemodialysis (control) were eligible. Data were collected between 01/01/2009 and 12/31/2021. The data collection period was up to 12 months for both control and intervention periods. The primary outcome was a composite of outcomes related to vascular access complications: hospitalisation, intervention, change in vascular access modality, change in dialysis modality and death. The primary outcome was evaluated by time-to-event rate in days using Kaplan-Meier plots. Statistical significance was accepted at a P < 0.05.
resultsOne hundred forty-five individuals were included: median age was 52.0 years (IQR 36.0-65.0), 71.0% (n = 103) were male, and 57.2% (n = 83) were White. The primary outcome occurred in 24.1% (n = 35) during the intervention and in 25.5% (n = 37) during the control period (P = 0.875). The 12-month vascular access survival probability was 73.4% (95%CI 65.8-81.0%) for the intervention and 70.6% (95%CI 62.4%-78.8%) for the control period. During the intervention period, arteriovenous grafts were associated with lower vascular access survival (P < 0.001). Regular vitamin K antagonist was associated with a lower 12-month vascular access survival for both the intervention (P = 0.044) and the control periods (P < 0.001).
conclusionThere does not appear to be an increased risk to vascular access events for INHD compared to daytime haemodialysis. Vascular access type and regular anticoagulation were associated with a reduced vascular access survival probability.
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