Nephrologist care for 12 months or more increases hemodialysis initiation with permanent vascular access

Daijo Inaguma, Ryoichi Ando, Masato Ikeda, Nobuhiko Joki, Fumihiko Koiwa, Yasuhiro Komatsu, Toshihumi Sakaguchi, Toshio Shinoda, Toshihiko Yamaka, Takashi Shigematsu

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Abstract

Background: The objective of this study was to evaluate the effect of early referral (ER) to nephrologists on the type of vascular access (VA) available for use at the time of initiation of maintenance hemodialysis (HD). In patients who have been followed by nephrologists for less than 3 months, management before the initiation of HD is often insufficient and urgent initiation of HD is often necessary; therefore, patients in this study were limited to those who had been followed for at least 3 months by nephrologists. Methods: Nine hundred and forty patients at 9 institutions affiliated to our study group were enrolled in this retrospective observational study. We defined patients followed up by nephrologists for at least 12 months as the early referral (ER) group and those followed for between 3 and 12 months as the late referral (LR) group. The type of VA available for use at the initiation of maintenance HD was compared between the groups. Results: Early referral was found to be significantly associated with the availability of a permanent VA, which included an arteriovenous fistula or arteriovenous graft, at the time of initiation of HD (odds ratio [OR] 1.705; P = 0.001). Multivariate analysis also revealed ER to be significantly associated with the availability of a permanent VA (OR 1.509; P = 0.023). Conclusion: Early referral was shown to be advantageous for increasing the likelihood of availability of a permanent VA, even after patients who had been followed up for less than 3 months by nephrologists were excluded.

Original languageEnglish
Pages (from-to)738-744
Number of pages7
JournalClinical and Experimental Nephrology
Volume15
Issue number5
DOIs
Publication statusPublished - 01-10-2011
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Physiology
  • Nephrology
  • Physiology (medical)

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    Inaguma, D., Ando, R., Ikeda, M., Joki, N., Koiwa, F., Komatsu, Y., Sakaguchi, T., Shinoda, T., Yamaka, T., & Shigematsu, T. (2011). Nephrologist care for 12 months or more increases hemodialysis initiation with permanent vascular access. Clinical and Experimental Nephrology, 15(5), 738-744. https://doi.org/10.1007/s10157-011-0472-7