ArticleInternal medicine journal2026
Back-up arteriovenous fistula in peritoneal dialysis patients: a retrospective cohort study of long-term meaningful outcomes.
Article in Internal medicine journal, 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
backgroundBack-up arteriovenous fistula (bAVF) is used in peritoneal dialysis (PD) to avoid haemodialysis transfer via a central venous catheter (CVC). However, no previous study examined mortality or complications associated with bAVF creation.
aimsComparing mortality, haemodialysis transfer overall or with a CVC and vascular access complications (bAVF or CVC) between patients with a bVF and those with no bAVF.
methodsA retrospective cohort study of adult PD patients within an Australian Local Health District (2017-2023). Cox regression models were used for hazard ratios (HR) and 95% confidence intervals (95% CI).
resultsOf 115 patents followed up (median of 1.9 years (interquartile range 0.9, 3.5)), 50 (44%) had a bAVF of which 31 (62%) matured. The bAVF group had 56 procedures (1.1/patient), including 32 assisted interventions (0.6/patient). There was no associated difference in mortality between bAVF and no bAVF group (HR 0.8, 95% CI 0.4-1.6, P = 0.6) or haemodialysis transfer (HR 1.0, 95% CI 0.5-2.0, P = 0.9). A bAVF was associated with a lower haemodialysis transfer risk with a CVC (HR 0.4, 95% CI 0.1-0.9, P = 0.04). Complications between the bAVF and no bAVF group were similar (28% vs 14%, P = 0.06).
conclusionbAVF were associated with lower risk of haemodialysis transfer to haemodialysis with a CVC, compared to those with no bAVF. However, there was no difference in mortality, risk of transferring to haemodialysis or complications.
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