Effect of kidney transplantation activity on arteriovenous fistula use in prevalent haemodialysis patients: A registry-based study.

IF 4.9 1区管理学 Q1 MANAGEMENT

Organization Studies Pub Date : 2023-11-01 Epub Date: 2022-04-08 DOI:10.1177/11297298221089851

Ramon Roca-Tey, Jordi Comas, Jaume Tort

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引用次数: 1

Abstract

Background: Kidney transplantation (KT) is considered to be the best kidney replacement therapy (KRT) option for most end-stage kidney disease (ESKD) patients. Arteriovenous fistula (AVF) is considered to be the best vascular access (VA) for most haemodialysis (HD) patients. In this study, we investigated the effect of KT activity on AVF use in prevalent HD patients. The probability of receiving a kidney graft (KTx) over time, depending on the first VA used to start the HD program, was also evaluated.

Methods: Data from the Catalan Registry of prevalent patients on KRT by either KT or HD were examined over a 20-year period (1997-2017).

Results: The percentage of prevalent ESKD patients with a functioning KTx increased from 40.5% in 1997 to 57.0% in 2017 and, conversely, the percentage of AVF utilisation in HD patients decreased from 86.0% to 63.2% during the same period (for both comparisons, p < 0.001). This inverse relationship was also demonstrated in other countries and regions worldwide by performing a simple linear regression analysis (R² = 0.4974, p = 0.002). The probability of prevalent patients dialysed through an AVF in Catalonia was independently associated with the percentage of functioning KTx among KRT population, after adjusting by age, gender, primary kidney disease, time on KRT, cardiovascular disease and type of HD Unit. Incident patients starting HD through an AVF had a significantly higher probability of receiving a KTx over time in comparison to patients who initiated HD through a catheter (hazard ratio 1.68 [95% confidence interval: 1.41-2.00], p < 0.001).

Conclusions: In addition to some demographical and clinical characteristics of patients and type of HD Unit, KT activity can be a determining factor in AVF use in prevalent HD patients. Starting an HD programme through an AVF is independently associated with a greater probability of receiving a KTx as compared to starting HD through a catheter.

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肾移植活动对流行性血液透析患者动静脉内瘘使用的影响：一项基于登记的研究。

背景：肾移植（KT）被认为是大多数终末期肾病（ESKD）患者的最佳肾脏替代疗法（KRT）选择。动静脉瘘（AVF）被认为是大多数血液透析（HD）患者的最佳血管通路（VA）。在这项研究中，我们调查了 KT 活动对流行性 HD 患者使用动静脉内瘘的影响。我们还评估了随着时间的推移接受肾脏移植（KTx）的概率，这取决于开始血液透析计划时使用的第一个血管通路：方法：研究了加泰罗尼亚登记处在 20 年内（1997-2017 年）通过 KT 或 HD 进行 KRT 患者的数据：具有正常 KTx 的 ESKD 患者比例从 1997 年的 40.5%增至 2017 年的 57.0%，相反，同期 HD 患者使用 AVF 的比例从 86.0% 降至 63.2%（两组比较，P R2 = 0.4974，P = 0.002）。在根据年龄、性别、原发性肾脏疾病、接受 KRT 治疗的时间、心血管疾病和 HD 单元类型进行调整后，加泰罗尼亚地区通过 AVF 进行透析的患者的患病概率与 KRT 患者中 KTx 功能正常的百分比独立相关。与通过导管开始 HD 的患者相比，通过 AVF 开始 HD 的患者随着时间的推移接受 KTx 的概率明显更高（危险比为 1.68 [95% 置信区间：1.41-2.00]，P 结论）：除了患者的一些人口统计学和临床特征以及血液透析装置的类型外，KT 活动也是流行性血液透析患者使用 AVF 的决定性因素。与通过导管开始血液透析相比，通过 AVF 开始血液透析计划与接受 KTx 的更大概率独立相关。

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

Organization Studies MANAGEMENT-

CiteScore

11.50

自引率

16.70%

发文量

期刊介绍： Organisation Studies (OS) aims to promote the understanding of organizations, organizing and the organized, and the social relevance of that understanding. It encourages the interplay between theorizing and empirical research, in the belief that they should be mutually informative. It is a multidisciplinary peer-reviewed journal which is open to contributions of high quality, from any perspective relevant to the field and from any country. Organization Studies is, in particular, a supranational journal which gives special attention to national and cultural similarities and differences worldwide. This is reflected by its international editorial board and publisher and its collaboration with EGOS, the European Group for Organizational Studies. OS publishes papers that fully or partly draw on empirical data to make their contribution to organization theory and practice. Thus, OS welcomes work that in any form draws on empirical work to make strong theoretical and empirical contributions. If your paper is not drawing on empirical data in any form, we advise you to submit your work to Organization Theory – another journal under the auspices of the European Group for Organizational Studies (EGOS) – instead.