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NDT Advance Access originally published online on December 15, 2005
Nephrology Dialysis Transplantation 2006 21(5):1453-1454; doi:10.1093/ndt/gfi330
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© The Author [2005.] Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Letter

Survival and infection rates of a polyurethane vascular access graft compared to tunnelled dialysis catheters and brachiobasilic arteriovenous fistulas

Email: abmw100{at}doctors.org.uk

Sir,

The polyurethane graft can be used within 24 h and has improved haemostasis after cannulation [1,2]. It may be an alternative to central venous catheters in situations where urgent access is needed and native arteriovenous fistulas sites have been exhausted. We performed a retrospective review of all polyurethane grafts, all brachiobasilic fistulas (BBAVF) and age- and sex-matched controls with a tunnelled central venous access catheter (CVC) in a 27 month period. Patency, defined as dialysis-days, was analysed using life-table analysis methods.


Figure 1
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  		Fig. 1. Survival curves according to access type. Analysis time is measured in months.

 
Results. The groups were similar in terms of age, sex, diabetes and causes of renal failure. Six out of 21 BBAVF (29%) failed to mature. Patency of the polyurethane grafts, CVC and BBAVFs were similar (log-rank test {chi}2 = 0.34; P = 0.84). The overall infection rate in the CVC group and the graft group was similar. More than half of the infections occurred in only five leg grafts. This was significantly higher than in the arm ({chi}2 = 4.7; P = 0.03). No serious infection, requiring ligation of the fistula, was seen in the BBAVF group. The polyurethane graft is an alternative to the tunnelled CVC in patients who need urgent dialysis access when the options for simple arteriovenous fistulas are exhausted.

Conflict of interest statement. None declared.

Teun Wilmink1, Claire Brown1, Carl Richardson2, Martin Claridge1, Martin Ferring2, Hugh Rayner2 and Steve Smith2

1 Department of Vascular Surgery2 Department of Renal Medicine Birmingham Heartlands Hospital Birmingham UK

References

  1. Glickman MH, Stokes GK, Ross JR et al. Multicenter evaluation of a polytetrafluoroethylene vascular access graft as compared with the expanded polytetrafluoroethylene vascular access graft in hemodialysis applications. J Vasc Surg 2001; 34: 465–473[CrossRef][ISI][Medline]
  2. Peng CW, Tan SG. Polyurethane grafts: a viable alternative for dialysis arteriovenous access? Asian Cardiovasc Thorac Ann 2003; 11: 314–318[Abstract/Free Full Text]

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This Article
Right arrow Extract Freely available
Right arrow FREE Full Text (PDF) Freely available
Right arrow All Versions of this Article:
21/5/1453    most recent
gfi330v1
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Right arrow Articles by Smith, S.
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PubMed
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