Comparing Long Term Hemodialysis Access Survival between two Non-Autogenous Conduits

dc.creatorIslam, Tasnim
dc.description.abstractObjectives: In end stage renal disease population, there has been an increase in the utilization of non-autogenous conduits for hemodialysis access over the past decade. In this study, we compare long term functional patency between two non-autogenous conduits: bovine biograft and polytetrafluoroethylene (PTFE). Methods: Study include 120 grafts placed in 98 patients between January 2011 and June 2014 in our institution. Various statistical analyses were run via Univariate methods and Kaplan-Meier and Cox regression to evaluate time to loss of patency and identify its predictors. Log rank tests were used to compute differences in survival functions between both groups. Follow-up began at the first time the graft was used for dialysis and ended with an event such as death or study closure. Results: There was no difference in the survival for functionality between PTFE and biograft (Table 1). There was a six fold increase in the loss of functional secondary patency in PTFE compared to biograft (HR: 6.8 95%CI: 1.7-26.3, P=0.006). The survival function for secondary patency was higher for biografts compared to PTFE (x2=7.69, p=0.02). Functional secondary patency at 6months, 1 year and 18 months for biograft and PTFE are 76%, 72%, 72% and 52%, 46%, 46% respectively. Graft infection rates were higher for PTFE compared to biografts (21% Vs 15%). The predictors of patency loss were high-BMI and hyperlipidemia. Conclusions: In our cohort, intervention-free access survival and thrombosis-free access survival are similar between biografts and prosthetic conduits. But, bovine biografts have a significant advantage over PTFE with regards to access survival until abandoned. Patients with high BMI and hyperlipidemia attracted close graft monitoring to improve access survival.
dc.titleComparing Long Term Hemodialysis Access Survival between two Non-Autogenous Conduits