ArticleThe journal of vascular access2026
Timely AVF creation in late-referral hemodialysis patients, a two-cohort study: Too late to plan, not too late to act.
Article in The journal of vascular access, 2026. 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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Abstract
backgroundTimely vascular access creation in end-stage kidney disease is critical for optimizing patient outcomes. While early nephrology referral (⩾90 days pre-dialysis) improves access patency and survival, late referral is associated with worse outcomes. Healthcare system structure and demographics may impact vascular access strategies. This study compared late-referral hemodialysis patients from two high-volume hospitals in different healthcare systems, focusing on vascular access and survival.
methodsThis retrospective, two-center study included 463 late-referral hemodialysis patients (mean age 60.4 ± 15.8 years; 63.3% male) initiating dialysis with a tunneled CVC between January 2020 and May 2024 at King's College Hospital, London ( PRIMARY OUTCOME: all-cause mortality. SECONDARY OUTCOMES: AVF creation, primary and secondary AVF patency, and CRBSI.
resultsAVF recipients had significantly lower mortality than non-AVF patients (
conclusionsEarly AVF creation in late-referral hemodialysis patients improves survival and reduces CRBSI risk. Reducing CVC requirement, especially in AVF-eligible patients, is a key strategy to improve outcomes.
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