The prognostic significance of puncture timing to survival of arteriovenous fistulas in hemodialysis patients: A multicenter retrospective cohort study

Su Ju Lin, Chun Wu Tung, Yung Chien Hsu, Ya Hsueh Shih, Yi Ling Wu, Tse Chih Chou, Shu Chen Chang*, Chun Liang Lin

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

7 Scopus citations

Abstract

(1) Background: A functional shunt is critical to hemodialysis, but the ideal timing of shunt cannulation is still not established. In this study, we assessed the association between ideal puncture timing and shunt survival. (2) Methods: This retrospective cohort study using data from the Taiwan Health andWelfare database, which included 26885 hemodialysis patients with arteriovenous fistulas from 1 July 2008 to 30 June 2012. Fistulas were categorized by functional maturation time, defined as the time from the date of shunt construction to the first successful cannulation. Functional cumulative survival, measured as the duration from the first puncture to shunt abandonment, was mainly regarded. (3) Results: The fistulas created between 91 and 180 days prior to the first cannulation had significantly greater cumulative functional survival (HR 0.883; 95% CI 0.792-0.984), and there was no more benefit on their survival from waiting more than 180 days (HR 0.957; 95% CI 0.853-1.073) for shunt maturity. (4) Conclusions: Our results showed that to achieve better long-term shunt survivals, fistulas should be constructed at least 90 days before starting hemodialysis. Notably, there was no additional benefit on waiting more than 180 days prior to cannulation.

Original languageEnglish
Article number247
JournalJournal of Clinical Medicine
Volume8
Issue number2
DOIs
StatePublished - 02 2019

Bibliographical note

Publisher Copyright:
© 2019 by the authors. Licensee MDPI, Basel, Switzerland.

Keywords

  • Arteriovenous fistula
  • Hemodialysis
  • Maturation time
  • Puncture time
  • Survival

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