Abstract | BACKGROUND: METHODS: The Preservation of Vascular Access Study was designed to investigate the effectiveness of patch use in reducing failure rates of arteriovenous fistulas or grafts. Data from medical records of patients who received hemodialysis from January 2001 to December 2005 at local ambulatory outpatient hemodialysis units in Charleston, South Carolina were analyzed. To explore whether greater use of the poly-N-acetyl glucosamine patch resulted in more favorable outcomes, patients were categorized into no patch use (n = 183) or 2 groups involving patch use, <70% of hemodialysis sessions (n = 88) or >or=70% of hemodialysis sessions (n = 64). The outcome measure was failure of access site estimated using Poisson regression models. RESULTS: Three hundred thirty-five patients (54% women) with 178 fistulas (44%) and 227 grafts (56%) were included. The study population was predominantly African American (84%), with a median age of 58 years. The adjusted relative rate of access failure involving patch use in <70% of hemodialysis sessions versus no patch use was 0.84 (95% CI, 0.37-1.94), and for patch use in >or=70% of hemodialysis sessions versus no patch use was 0.40 (95% CI, 0.16-1.02; trend P = 0.045). CONCLUSIONS: The Preservation of Vascular Access Study results are consistent with improved access survival with frequent patch use. The application of patch in this population is a simple, well-accepted intervention and warrants further investigation.
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Authors | Aynur Unalp, David W Ploth, Ryan Colvin, Caroline Counts, Pamela H Shepp, Mark L Van Natta, Curtis L Meinert |
Journal | The American journal of the medical sciences
(Am J Med Sci)
Vol. 338
Issue 3
Pg. 178-84
(Sep 2009)
ISSN: 1538-2990 [Electronic] United States |
PMID | 19745608
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Chemical References |
- poly-N-acetyl glucosamine
- Acetylglucosamine
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Topics |
- Acetylglucosamine
(administration & dosage)
- Female
- Graft Rejection
(prevention & control)
- Hemostasis
- Humans
- Kidney Failure, Chronic
(surgery)
- Kidney Transplantation
- Male
- Middle Aged
- Renal Dialysis
(methods)
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