{"title":"Effect of kidney transplantation activity on arteriovenous fistula use in prevalent haemodialysis patients: A registry-based study.","authors":"Ramon Roca-Tey, Jordi Comas, Jaume Tort","doi":"10.1177/11297298221089851","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Methods: </strong>Data from the Catalan Registry of prevalent patients on KRT by either KT or HD were examined over a 20-year period (1997-2017).</p><p><strong>Results: </strong>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, <i>p</i> < 0.001). This inverse relationship was also demonstrated in other countries and regions worldwide by performing a simple linear regression analysis (<i>R</i><sup>2</sup> = 0.4974, <i>p</i> = 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], <i>p</i> < 0.001).</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":48423,"journal":{"name":"Organization Studies","volume":"29 1","pages":"1381-1389"},"PeriodicalIF":4.9000,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"1","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Organization Studies","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1177/11297298221089851","RegionNum":1,"RegionCategory":"管理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2022/4/8 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"MANAGEMENT","Score":null,"Total":0}
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.
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.
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