Cross-sectional study of quality of life in relation with vascular access in hemodialysis patients

Abstract

Introduction: Vascular access for hemodialysis (HD) is essential for the patient. Even though Arteriovenous fistula (AVF) is the preferred access, in certain age groups, the central venous catheter (CVC) may provide advantages. This study aims to investigate the quality of life related to vascular access. Methods: Cross-sectional study including patients from a hospital, a home HD unit and a satellite hemodialysis center. Clinical data was collected from the patients, who went through a quality-of-life questionnaire SF12 and a Vascular Access Questionnaire (VAQ). Results: 91 patients participated, mostly male (70%), with a mean age of 68.9 ± 16.2 years. AVF was the current vascular access in 60.4%, the rest used a CVC. Home HD was performed in 12.1% of patients and 76% started it via CVC. Regarding patients who have had both AVF and CVC, 58% prefer AVF and only 26.5% of current CVC carriers would have a new AVF, mostly due to fear of pain (52%). Most people (72.5%) reported having received sufficient information, with no differences between both accesses. The SF12 results showed no differences between patients with AVF or CVC. Regarding the VAQ, patients with AVF were more satisfied with the social aspect (p = 0.036) and complications (p = 0.006). Conclusion: Patients with AVF had better outcomes than those using CVC regarding complications and social aspects. These differences are not attributable to a worse overall quality of life status of CVC patients. Most patients with CVCs refuse to go through a new AVF for fear of puncture pain.