Pub Date : 2024-05-01DOI: 10.1016/j.nefro.2023.06.009
Álvaro Marchán-López
{"title":"Effect of early treatment with dapagliflozin on the natural history of chronic kidney disease","authors":"Álvaro Marchán-López","doi":"10.1016/j.nefro.2023.06.009","DOIUrl":"10.1016/j.nefro.2023.06.009","url":null,"abstract":"","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"44 3","pages":"Pages 435-436"},"PeriodicalIF":2.6,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0211699523001017/pdfft?md5=228652e483f2bd1f71d768e69e430166&pid=1-s2.0-S0211699523001017-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43863416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-01DOI: 10.1016/j.nefro.2023.07.001
José C. de la Flor , Leonidas Cruzado , Javier Deira , Francisco Valga , Beatriz Sualdea , Rocío Zamora , Miguel Rodeles
{"title":"Manejo del prurito refractario con difelikefalina en un paciente en hemodiálisis incremental de un día a la semana. ¿Es seguro y eficaz?","authors":"José C. de la Flor , Leonidas Cruzado , Javier Deira , Francisco Valga , Beatriz Sualdea , Rocío Zamora , Miguel Rodeles","doi":"10.1016/j.nefro.2023.07.001","DOIUrl":"10.1016/j.nefro.2023.07.001","url":null,"abstract":"","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"44 3","pages":"Pages 437-439"},"PeriodicalIF":2.6,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S021169952300108X/pdfft?md5=d5e73e559f0153eae6b25fbf944546fe&pid=1-s2.0-S021169952300108X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43903540","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-01DOI: 10.1016/j.nefro.2023.08.001
Maria Luz Sánchez Tocino , Secundino Cigarrán , Pablo Ureña , Maria Luisa González Casaus , Sebastian Mas-Fontao , Carolina Gracia Iguacel , Alberto Ortíz , Emilio Gonzalez Parra
Sarcopenia and dynapenia are two terms associated with ageing that respectively define the loss of muscle mass and strength. In 2018, the European Working Group on Sarcopenia in Older People (EWGSOP) introduced the EWGSOP2 diagnostic algorithm for sarcopenia, which integrates both concepts. It consists of four sequential steps: screening for sarcopenia, examination of muscle strength, assessment of muscle mass and physical performance; depending on these last three aspects sarcopenia is categorised as probable, confirmed, and severe respectively. In the absence of validation of the EWGSOP2 algorithm in various clinical contexts, its use in haemodialysis poses several limitations: (a) low sensitivity of the screening, (b) the techniques that assess muscle mass are not very accessible, reliable, or safe in routine clinical care, (c) the sequential use of the magnitudes that assess dynapenia and muscle mass do not seem to adequately reflect the muscular pathology of the elderly person on dialysis. We reflect on the definition of sarcopenia and the use of more precise terms such as “myopenia” (replacing the classic concept of sarcopenia to designate loss of muscle mass), dynapenia and kratopenia. Prospective evaluation of EWGSOP2 and its comparison with alternatives (i.e. assessment of kratopenia and dynapenia only; steps 2 and 4) is proposed in terms of its applicability in clinical routine, resource consumption, identification of at-risk individuals and impact on events.
{"title":"Definición y evolución del concepto de sarcopenia","authors":"Maria Luz Sánchez Tocino , Secundino Cigarrán , Pablo Ureña , Maria Luisa González Casaus , Sebastian Mas-Fontao , Carolina Gracia Iguacel , Alberto Ortíz , Emilio Gonzalez Parra","doi":"10.1016/j.nefro.2023.08.001","DOIUrl":"10.1016/j.nefro.2023.08.001","url":null,"abstract":"<div><p>Sarcopenia and dynapenia are two terms associated with ageing that respectively define the loss of muscle mass and strength. In 2018, the European Working Group on Sarcopenia in Older People (EWGSOP) introduced the EWGSOP2 diagnostic algorithm for sarcopenia, which integrates both concepts. It consists of four sequential steps: screening for sarcopenia, examination of muscle strength, assessment of muscle mass and physical performance; depending on these last three aspects sarcopenia is categorised as probable, confirmed, and severe respectively. In the absence of validation of the EWGSOP2 algorithm in various clinical contexts, its use in haemodialysis poses several limitations: (a) low sensitivity of the screening, (b) the techniques that assess muscle mass are not very accessible, reliable, or safe in routine clinical care, (c) the sequential use of the magnitudes that assess dynapenia and muscle mass do not seem to adequately reflect the muscular pathology of the elderly person on dialysis. We reflect on the definition of sarcopenia and the use of more precise terms such as “myopenia” (replacing the classic concept of sarcopenia to designate loss of muscle mass), dynapenia and kratopenia. Prospective evaluation of EWGSOP2 and its comparison with alternatives (i.e. assessment of kratopenia and dynapenia only; steps 2 and 4) is proposed in terms of its applicability in clinical routine, resource consumption, identification of at-risk individuals and impact on events.</p></div>","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"44 3","pages":"Pages 323-330"},"PeriodicalIF":2.6,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0211699523001261/pdfft?md5=bc976a82a2a633396ec04664b2f50fa0&pid=1-s2.0-S0211699523001261-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41465004","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-01DOI: 10.1016/j.nefro.2023.10.005
José C. de la Flor , Esperanza Moral , Javier Deira , Tania Monzón , Francisco Valga , Cristina Albarracín , Miguel Rodeles
{"title":"Contestación a «Experiencia con dulaglutida en un paciente diabético y obeso en diálisis peritoneal incremental». Respuesta a carta relacionada","authors":"José C. de la Flor , Esperanza Moral , Javier Deira , Tania Monzón , Francisco Valga , Cristina Albarracín , Miguel Rodeles","doi":"10.1016/j.nefro.2023.10.005","DOIUrl":"10.1016/j.nefro.2023.10.005","url":null,"abstract":"","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"44 3","pages":"Pages 444-446"},"PeriodicalIF":2.6,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S021169952300156X/pdfft?md5=547ee2ac9c67b33ad440243078e2805f&pid=1-s2.0-S021169952300156X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135965848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-01DOI: 10.1016/j.nefro.2023.08.004
Alfonso Otero González
Chronic kidney disease is a serious public health problem and in clear relation to climate change and ecosystem maintenance. Renal health is particularly vulnerable to the impacts of climate change, and dialysis therapy (hemodialysis and PD) has a significant environmental footprint, conditioned by energy consumption and greenhouse gas production. In the last 50 years, people have changed ecosystems faster and more extensively than in any other period in human history. It is a consequence of ever-increasing demand for food, fresh water, fuel, industry, etc. and the result has been a substantial and largely irreversible loss of the diversity of life on Earth. Since 1979, human activities have caused the extinction of 60% of mammals, birds, fish and reptiles. There is an urgent need to adopt “Green Nephrology” measures by developing sustainable environmental solutions for the prevention and treatment of kidney diseases.
{"title":"Enfermedad renal crónica, diálisis y cambio climático","authors":"Alfonso Otero González","doi":"10.1016/j.nefro.2023.08.004","DOIUrl":"10.1016/j.nefro.2023.08.004","url":null,"abstract":"<div><p>Chronic kidney disease is a serious public health problem and in clear relation to climate change and ecosystem maintenance. Renal health is particularly vulnerable to the impacts of climate change, and dialysis therapy (hemodialysis and PD) has a significant environmental footprint, conditioned by energy consumption and greenhouse gas production. In the last 50 years, people have changed ecosystems faster and more extensively than in any other period in human history. It is a consequence of ever-increasing demand for food, fresh water, fuel, industry, etc. and the result has been a substantial and largely irreversible loss of the diversity of life on Earth. Since 1979, human activities have caused the extinction of 60% of mammals, birds, fish and reptiles. There is an urgent need to adopt “Green Nephrology” measures by developing sustainable environmental solutions for the prevention and treatment of kidney diseases.</p></div>","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"44 3","pages":"Pages 331-337"},"PeriodicalIF":2.6,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0211699523001297/pdfft?md5=c57ef3fa4eb910de9341de686a2c81b3&pid=1-s2.0-S0211699523001297-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47442464","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-01DOI: 10.1016/j.nefro.2023.10.003
Emilio González-Parra , Rafael Moreno-Gómez-Toledano , Sebastián Mas-Fontao , Ricardo J. Bosch
{"title":"Bisfenol A en la insuficiencia renal: ¿hasta cuándo se podrá usar? ¿Es la hora de evitarlo?","authors":"Emilio González-Parra , Rafael Moreno-Gómez-Toledano , Sebastián Mas-Fontao , Ricardo J. Bosch","doi":"10.1016/j.nefro.2023.10.003","DOIUrl":"10.1016/j.nefro.2023.10.003","url":null,"abstract":"","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"44 3","pages":"Pages 313-316"},"PeriodicalIF":2.6,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0211699523001546/pdfft?md5=7a000aaea8f9242c92e0e0cd36533266&pid=1-s2.0-S0211699523001546-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135809624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-01DOI: 10.1016/j.nefro.2023.08.003
Nicolle Fabiola Quiñonez Quiñones, Joel Antonio Santiago Ferrer, Cesar Abel Burga Cisterna
{"title":"Tratamientos y dietas asociadas a la hipertensión arterial resistente y su influencia en la eficacia de la espironolactona","authors":"Nicolle Fabiola Quiñonez Quiñones, Joel Antonio Santiago Ferrer, Cesar Abel Burga Cisterna","doi":"10.1016/j.nefro.2023.08.003","DOIUrl":"10.1016/j.nefro.2023.08.003","url":null,"abstract":"","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"44 3","pages":"Pages 439-440"},"PeriodicalIF":2.6,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0211699523001285/pdfft?md5=92d17edf105e9360fa43ddbf59555fa4&pid=1-s2.0-S0211699523001285-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136153715","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-01DOI: 10.1016/j.nefro.2023.08.010
Melissa Rau , Adrian Santelli , Sara Martí , María Isabel Díaz , Nuria Sabé , María Fiol , Luis Riera , Begoña Etcheverry , Sergi Codina , Ana Coloma , Anna Carreras-Salinas , Carmen Ardanuy , Josep M. Cruzado , Edoardo Melilli
Background
Studies analyzing non-antibiotic alternatives in kidney transplant UTI's are lacking. d-Mannose, a simple sugar, inhibits bacterial attachment to the urothelium, as does Proanthocyanidins; both could act as a synergic strategy preventing UTI; nonetheless their efficacy and safety have not been evaluated in kidney transplant population yet.
Methods
This is a pilot prospective, double-blind randomized trial. Sixty de novo kidney transplant recipients were randomized (1:1) to receive a prophylactic strategy based on a 24-h prolonged release formulation of d-Mannose plus Proanthocyanidins vs. Proanthocyanidins (PAC) alone. The supplements were taken for the first 3 months after kidney transplant and then followed up for 3 months as well. The main objective of the study was to search if the addition of Mannose to PAC alone reduced the incidence of UTI and/or asymptomatic bacteriuria in the first 6 months post-transplantation.
Results
27% of patients experienced one UTI episode (cystitis or pyelonephritis) while asymptomatic bacteriuria was very common (57%). Incidences according UTI type or AB were: 7% vs. 4% for cystitis episode (p 0.3), 4% vs. 5% for pyelonephritis (p 0.5) and 17% vs. 14% for asymptomatic bacteriuria (p 0.4) for patients in the Mannose + PAC group vs. PAC group respectively. The most frequent bacteria isolated in both groups was Escherichia coli (28% of all episodes), UTI or AB due to E. coli was not different according to study group (30% vs. 23% for Mannose + PAC vs. PAC alone p 0.37).
Conclusions
Non-antibiotic therapy is an unmet need to prevent UTI after kidney transplantation; however, the use of d-Mannose plus PAC does not seem capable to prevent it.
{"title":"Randomized clinical trial of non-antibiotic prophylaxis with d-Mannose plus Proanthocyanidins vs. Proanthocyanidins alone for urinary tract infections and asymptomatic bacteriuria in de novo kidney transplant recipients: The Manotras study","authors":"Melissa Rau , Adrian Santelli , Sara Martí , María Isabel Díaz , Nuria Sabé , María Fiol , Luis Riera , Begoña Etcheverry , Sergi Codina , Ana Coloma , Anna Carreras-Salinas , Carmen Ardanuy , Josep M. Cruzado , Edoardo Melilli","doi":"10.1016/j.nefro.2023.08.010","DOIUrl":"10.1016/j.nefro.2023.08.010","url":null,"abstract":"<div><h3>Background</h3><p>Studies analyzing non-antibiotic alternatives in kidney transplant UTI's are lacking. <span>d</span>-Mannose, a simple sugar, inhibits bacterial attachment to the urothelium, as does Proanthocyanidins; both could act as a synergic strategy preventing UTI; nonetheless their efficacy and safety have not been evaluated in kidney transplant population yet.</p></div><div><h3>Methods</h3><p>This is a pilot prospective, double-blind randomized trial. Sixty de novo kidney transplant recipients were randomized (1:1) to receive a prophylactic strategy based on a 24-h prolonged release formulation of <span>d</span>-Mannose plus Proanthocyanidins vs. Proanthocyanidins (PAC) alone. The supplements were taken for the first 3 months after kidney transplant and then followed up for 3 months as well. The main objective of the study was to search if the addition of Mannose to PAC alone reduced the incidence of UTI and/or asymptomatic bacteriuria in the first 6 months post-transplantation.</p></div><div><h3>Results</h3><p>27% of patients experienced one UTI episode (cystitis or pyelonephritis) while asymptomatic bacteriuria was very common (57%). Incidences according UTI type or AB were: 7% vs. 4% for cystitis episode (<em>p</em> 0.3), 4% vs. 5% for pyelonephritis (<em>p</em> 0.5) and 17% vs. 14% for asymptomatic bacteriuria (<em>p</em> 0.4) for patients in the Mannose<!--> <!-->+<!--> <!-->PAC group vs. PAC group respectively. The most frequent bacteria isolated in both groups was <em>Escherichia coli</em> (28% of all episodes), UTI or AB due to <em>E. coli</em> was not different according to study group (30% vs. 23% for Mannose<!--> <!-->+<!--> <!-->PAC vs. PAC alone <em>p</em> 0.37).</p></div><div><h3>Conclusions</h3><p>Non-antibiotic therapy is an unmet need to prevent UTI after kidney transplantation; however, the use of <span>d</span>-Mannose plus PAC does not seem capable to prevent it.</p></div>","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"44 3","pages":"Pages 408-416"},"PeriodicalIF":2.6,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0211699523001418/pdfft?md5=a9981eb2a562c00754a136320c6c391a&pid=1-s2.0-S0211699523001418-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46067005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-01DOI: 10.1016/j.nefro.2023.06.008
Bruno Fraga Dias , Joana Freitas , Fernanda Silva , Isabel Fonseca , Paulo Almeida , José Queirós
<div><h3>Introduction and objectives</h3><p>Functional and durable vascular access is needed for adequate hemodialysis. Arteriovenous fistula is preferred over prosthetic grafts or central venous catheters, but it is associated with high rates of primary failure and maturation failure.</p><p>Preoperative mapping of arm vessels with color Doppler ultrasound (CDU) has been shown to be helpful in achieving better short and long-term outcomes. Unfortunately, is more time-consuming than a physical examination and requires an experienced examiner and special equipment; some authors defend that CDU should not be part of the routine preoperative assessment.</p><p>We reported our experience in preoperative vessel mapping using color Doppler ultrasound to purpose a vascular access to the surgical team, surveillance of vascular access, and evaluation of main outcomes (primary failure, maturation failure, and patency).</p></div><div><h3>Methods</h3><p>This is a single-center retrospective study that includes patients who attended a specific appointment for vascular access planning consultation between January 2019 and December 2021. A nephrologist performed the physical exam and vascular mapping and proposed to the vascular surgeon team a specific type and location of vascular access. Patients were followed until one month after the first hemodialysis through functioning vascular access.</p></div><div><h3>Results</h3><p>In this study, 167 patients were evaluated (114 incident patients – chronic kidney disease stage 4 or 5 – and 53 prevalent patients – under hemodialysis through central venous catheter). The vascular accesses proposed by nephrologist were radial-cephalic arteriovenous fistula in 70 patients (41.9%), brachio-cephalic arteriovenous fistula in 50 patients (29.9%), brachio-basilic arteriovenous fistula in 34 patients (20.4%), arteriovenous graft in 8 patients (4.8%) and central venous catheter in 2 patients (1.2%).</p><p>Vascular access was constructed in 141 patients: distal arteriovenous fistula in 57 patients (40.4%), brachio-cephalic arteriovenous fistula in 54 patients (38.3%), brachio-basilic AVF in 27 patients (19.1%), and arteriovenous graft in 3 patients (2.1%). The created access corresponds to the proposed access in 129 patients (91.5%).</p><p>Twenty-two (15.6%) primary failures were registered. Distal arteriovenous fistulas and diabetes mellitus were associated with a higher risk of primary failure (OR<!--> <!-->=<!--> <!-->3.929 (1.485–10.392), <em>p</em> <!-->=<!--> <!-->0.004; OR<!--> <!-->=<!--> <!-->3.867 (1.235–12.113), <em>p</em> <!-->=<!--> <!-->0.014, respectively).</p><p>The incidence of maturation failure at eight weeks was 4.8%.</p><p>The primary patency at 6, 12 and 24 months was 76.3%, 70.4% and 49.2%. Primary assisted patency was 84.8% at 6 and 12 months and 81.3% at 24 months.</p></div><div><h3>Conclusions</h3><p>This study demonstrates that the study of the entire vascular territory performed with color Doppler ultras
{"title":"Preoperative mapping and multidisciplinary team are the key to success of arteriovenous access for hemodialysis","authors":"Bruno Fraga Dias , Joana Freitas , Fernanda Silva , Isabel Fonseca , Paulo Almeida , José Queirós","doi":"10.1016/j.nefro.2023.06.008","DOIUrl":"10.1016/j.nefro.2023.06.008","url":null,"abstract":"<div><h3>Introduction and objectives</h3><p>Functional and durable vascular access is needed for adequate hemodialysis. Arteriovenous fistula is preferred over prosthetic grafts or central venous catheters, but it is associated with high rates of primary failure and maturation failure.</p><p>Preoperative mapping of arm vessels with color Doppler ultrasound (CDU) has been shown to be helpful in achieving better short and long-term outcomes. Unfortunately, is more time-consuming than a physical examination and requires an experienced examiner and special equipment; some authors defend that CDU should not be part of the routine preoperative assessment.</p><p>We reported our experience in preoperative vessel mapping using color Doppler ultrasound to purpose a vascular access to the surgical team, surveillance of vascular access, and evaluation of main outcomes (primary failure, maturation failure, and patency).</p></div><div><h3>Methods</h3><p>This is a single-center retrospective study that includes patients who attended a specific appointment for vascular access planning consultation between January 2019 and December 2021. A nephrologist performed the physical exam and vascular mapping and proposed to the vascular surgeon team a specific type and location of vascular access. Patients were followed until one month after the first hemodialysis through functioning vascular access.</p></div><div><h3>Results</h3><p>In this study, 167 patients were evaluated (114 incident patients – chronic kidney disease stage 4 or 5 – and 53 prevalent patients – under hemodialysis through central venous catheter). The vascular accesses proposed by nephrologist were radial-cephalic arteriovenous fistula in 70 patients (41.9%), brachio-cephalic arteriovenous fistula in 50 patients (29.9%), brachio-basilic arteriovenous fistula in 34 patients (20.4%), arteriovenous graft in 8 patients (4.8%) and central venous catheter in 2 patients (1.2%).</p><p>Vascular access was constructed in 141 patients: distal arteriovenous fistula in 57 patients (40.4%), brachio-cephalic arteriovenous fistula in 54 patients (38.3%), brachio-basilic AVF in 27 patients (19.1%), and arteriovenous graft in 3 patients (2.1%). The created access corresponds to the proposed access in 129 patients (91.5%).</p><p>Twenty-two (15.6%) primary failures were registered. Distal arteriovenous fistulas and diabetes mellitus were associated with a higher risk of primary failure (OR<!--> <!-->=<!--> <!-->3.929 (1.485–10.392), <em>p</em> <!-->=<!--> <!-->0.004; OR<!--> <!-->=<!--> <!-->3.867 (1.235–12.113), <em>p</em> <!-->=<!--> <!-->0.014, respectively).</p><p>The incidence of maturation failure at eight weeks was 4.8%.</p><p>The primary patency at 6, 12 and 24 months was 76.3%, 70.4% and 49.2%. Primary assisted patency was 84.8% at 6 and 12 months and 81.3% at 24 months.</p></div><div><h3>Conclusions</h3><p>This study demonstrates that the study of the entire vascular territory performed with color Doppler ultras","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"44 3","pages":"Pages 344-353"},"PeriodicalIF":2.6,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0211699523001005/pdfft?md5=7ae751ef8ad3a6dead6e16c0a1acbb45&pid=1-s2.0-S0211699523001005-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47638508","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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