Preemptive Vascular Access Placement and Mortality Risk in Hemodialysis Patients: A Real-World Single-Center Study

IF 1.4 4区医学 Q3 UROLOGY & NEPHROLOGY

Hemodialysis International Pub Date : 2026-07-09 Epub Date: 2026-05-13 DOI:10.1111/hdi.70082

Wei Wang, Buyuan Tian, Xumao Deng, Ya Feng, Aijing Huang, Zaicheng Hu, Simeng Li, Cong Peng, Xiang Xiao

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引用次数: 0

Abstract

Background

The optimal timing for vascular access creation in hemodialysis (HD) patients is critical for improving patient outcomes. This study aimed to investigate the association between preemptive vascular access placement and all-cause mortality in HD patients.

Methods

A retrospective cohort of 489 adult HD patients from 2009 to 2022 was analyzed. Patients were categorized into preemptive and non-preemptive vascular access groups. Inverse probability of treatment weighting (IPTW) was used to balance baseline characteristics, and survival analyses were performed using Kaplan–Meier curves, log-rank tests, and Cox proportional hazards models.

Results

Preemptive vascular access was found in 20.7% (101/489) of patients. After IPTW adjustment, the preemptive group had lower mortality (8.9% vs. 18.8%, p < 0.001) and a 65% reduction in all-cause mortality risk (adjusted HR = 0.35, 95% CI 0.15–0.80). Elderly patients (≥ 60 years) showed greater survival benefits (p for interaction < 0.05).

Conclusions

Preemptive vascular access placement significantly improves survival in HD patients, particularly in older adults. However, excessively early placement (> 6 months) offers no additional prognostic advantage.

查看原文本刊更多论文

血透患者的血管通路放置和死亡风险：一项真实世界的单中心研究。

背景：血液透析（HD）患者血管通路建立的最佳时机对改善患者预后至关重要。本研究旨在探讨HD患者抢先血管通路放置与全因死亡率之间的关系。方法：对2009 ~ 2022年489例成人HD患者进行回顾性队列分析。患者分为先占性血管通路组和非先占性血管通路组。使用治疗加权逆概率（IPTW）来平衡基线特征，使用Kaplan-Meier曲线、log-rank检验和Cox比例风险模型进行生存分析。结果：20.7%（101/489）的患者发现了血管抢先通路。调整IPTW后，先置组的死亡率较低（8.9% vs. 18.8%）。结论：先置血管通路可显著提高HD患者的生存率，尤其是老年人。然而，过早放置（6个月左右）没有额外的预后优势。

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

Hemodialysis International UROLOGY & NEPHROLOGY-

CiteScore

2.50

自引率

0.00%

发文量

审稿时长

6-12 weeks

期刊介绍： Hemodialysis International was originally an annual publication containing the Proceedings of the International Symposium on Hemodialysis held in conjunction with the Annual Dialysis Conference. Since 2003, Hemodialysis International is published quarterly and contains original papers on clinical and experimental topics related to dialysis in addition to the Annual Dialysis Conference supplement. This journal is a must-have for nephrologists, nurses, and technicians worldwide. Quarterly issues of Hemodialysis International are included with your membership to the International Society for Hemodialysis. The journal contains original articles, review articles, and commentary to keep readers completely updated in the field of hemodialysis. Edited by international and multidisciplinary experts, Hemodialysis International disseminates critical information in the field.