Impact of prepared vascular access on mortality and medical expenses in elderly and non-elderly Japanese patients with chronic kidney disease stage G5: a retrospective cohort study.

IF 2.2 4区医学 Q2 UROLOGY & NEPHROLOGY

Clinical and Experimental Nephrology Pub Date : 2025-03-18 DOI:10.1007/s10157-025-02654-3

Takayuki Nimura, Makoto Harada, Daiki Aomura, Kosuke Yamaka, Koji Hashimoto, Yuji Kamijo

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引用次数: 0

Abstract

Background: Patients with chronic kidney disease (CKD) stage 5 (CKDG5) have greater dialysis requirements that increase the risk of cardiovascular disease and mortality. The elevated costs associated with CKDG5 are a serious concern. The impact of prepared vascular access (VA) through planned VA creation on mortality and medical expenses remains unclear in Japanese patients with CKDG5.

Methods: We conducted a retrospective cohort study including 157 patients with CKD who started hemodialysis (HD) at Shinshu University Hospital from April 2016 to March 2021 and assessed the relationship between the presence of a prepared VA and mortality and hospitalization expenses in elderly and non-elderly patients with CKDG5.

Results: The presence of a prepared VA was associated with lower mortality in non-elderly patients but not in elderly patients. Medical expenses, emergency HD, and hospitalization duration were significantly lower in patients with a prepared VA in both age groups. The contribution of a prepared VA to mortality and medical expenses remained consistent after adjusting for sex, performance status, comorbidities, and nutritional status.

Conclusion: A prepared VA showed several benefits, including lower mortality rates and hospitalization costs; shorter hospital stays; and higher home discharge rates. Planned VA creation was significantly associated with lower hospitalization expenses, irrespective of age.

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准备好的血管通路对日本老年和非老年慢性肾病 G5 期患者死亡率和医疗费用的影响：一项回顾性队列研究。

背景：慢性肾脏疾病（CKD） 5期（CKDG5）患者有更大的透析需求，这增加了心血管疾病和死亡的风险。CKDG5相关的高成本是一个严重的问题。在日本CKDG5患者中，通过计划血管通路（VA）建立预备血管通路（VA）对死亡率和医疗费用的影响尚不清楚。方法：我们进行了一项回顾性队列研究，纳入了2016年4月至2021年3月在信州大学医院开始血液透析（HD）的157例CKD患者，评估了老年和非老年CKDG5患者中准备好的VA与死亡率和住院费用之间的关系。结果：制备VA的存在与非老年患者的较低死亡率相关，而与老年患者无关。两组患者的医疗费用、急诊HD和住院时间均显著降低。在调整性别、工作状况、合并症和营养状况后，准备好的退伍军人对死亡率和医疗费用的贡献保持一致。结论：制备的VA具有以下几个优点，包括降低死亡率和住院费用；缩短住院时间；以及更高的家庭出院率。无论年龄大小，计划的VA创建与较低的住院费用显著相关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical and Experimental Nephrology UROLOGY & NEPHROLOGY-

CiteScore

4.10

自引率

4.30%

发文量

135

审稿时长

4-8 weeks

期刊介绍： Clinical and Experimental Nephrology is a peer-reviewed monthly journal, officially published by the Japanese Society of Nephrology (JSN) to provide an international forum for the discussion of research and issues relating to the study of nephrology. Out of respect for the founders of the JSN, the title of this journal uses the term “nephrology,” a word created and brought into use with the establishment of the JSN (Japanese Journal of Nephrology, Vol. 2, No. 1, 1960). The journal publishes articles on all aspects of nephrology, including basic, experimental, and clinical research, so as to share the latest research findings and ideas not only with members of the JSN, but with all researchers who wish to contribute to a better understanding of recent advances in nephrology. The journal is unique in that it introduces to an international readership original reports from Japan and also the clinical standards discussed and agreed by JSN.