A comparison of arteriovenous fistula failure between Malaysian and Australian and New Zealand participants enrolled in the FAVOURED trial.

Arteriovenous fistula aspirin cannulation failure fish oils haemodialysis kidney failure vascular access outcome

Journal

The journal of vascular access
ISSN: 1724-6032
Titre abrégé: J Vasc Access
Pays: United States
ID NLM: 100940729

Informations de publication

Date de publication:
10 Jun 2022
Historique:
entrez: 10 6 2022
pubmed: 11 6 2022
medline: 11 6 2022
Statut: aheadofprint

Résumé

To describe and compare de novo arteriovenous fistula (AVF) failure rates between Australia and New Zealand (ANZ), and Malaysia. AVFs are preferred for haemodialysis access but are limited by high rates of early failure. A post hoc analysis of 353 participants from ANZ and Malaysia included in the FAVOURED randomised-controlled trial undergoing de novo AVF surgery was performed. Composite AVF failure (thrombosis, abandonment, cannulation failure) and its individual components were compared between ANZ ( Participants' mean age was 55 ± 14.3 years and 64% were male. Compared with ANZ participants, Malaysian participants were younger with lower body mass index, higher prevalence of diabetes mellitus and lower prevalence of cardiovascular disease. AVF failure was less frequent in the Malaysian cohort (38% vs 54%; adjusted odds ratio (OR) 0.53, 95% confidence interval (CI) 0.31-0.93). This difference was driven by lower odds of cannulation failure (29% vs 47%, OR 0.45, 95% CI 0.25-0.80), while the odds of AVF thrombosis (17% vs 20%, OR 1.24, 95% CI 0.62-2.48) and abandonment (25% vs 23%, OR 1.17, 95% CI 0.62-2.16) were similar. The risk of AVF failure was significantly lower in Malaysia compared to ANZ and driven by a lower risk of cannulation failure. Differences in practice patterns, including patient selection, surgical techniques, anaesthesia or cannulation techniques may account for regional outcome differences and warrant further investigation.

Sections du résumé

AIM UNASSIGNED
To describe and compare de novo arteriovenous fistula (AVF) failure rates between Australia and New Zealand (ANZ), and Malaysia.
BACKGROUND UNASSIGNED
AVFs are preferred for haemodialysis access but are limited by high rates of early failure.
METHODS UNASSIGNED
A post hoc analysis of 353 participants from ANZ and Malaysia included in the FAVOURED randomised-controlled trial undergoing de novo AVF surgery was performed. Composite AVF failure (thrombosis, abandonment, cannulation failure) and its individual components were compared between ANZ (
RESULTS UNASSIGNED
Participants' mean age was 55 ± 14.3 years and 64% were male. Compared with ANZ participants, Malaysian participants were younger with lower body mass index, higher prevalence of diabetes mellitus and lower prevalence of cardiovascular disease. AVF failure was less frequent in the Malaysian cohort (38% vs 54%; adjusted odds ratio (OR) 0.53, 95% confidence interval (CI) 0.31-0.93). This difference was driven by lower odds of cannulation failure (29% vs 47%, OR 0.45, 95% CI 0.25-0.80), while the odds of AVF thrombosis (17% vs 20%, OR 1.24, 95% CI 0.62-2.48) and abandonment (25% vs 23%, OR 1.17, 95% CI 0.62-2.16) were similar.
CONCLUSIONS UNASSIGNED
The risk of AVF failure was significantly lower in Malaysia compared to ANZ and driven by a lower risk of cannulation failure. Differences in practice patterns, including patient selection, surgical techniques, anaesthesia or cannulation techniques may account for regional outcome differences and warrant further investigation.

Identifiants

pubmed: 35686506
doi: 10.1177/11297298221099134
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

11297298221099134

Auteurs

Rebecca Hudson (R)

Department of Nephrology, Princess Alexandra Hospital, Brisbane, QLD, Australia.

Elaine M Pascoe (EM)

Australasian Kidney Trials Network, Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia.

Yong Pey See (YP)

Department of Nephrology, Princess Alexandra Hospital, Brisbane, QLD, Australia.
Australasian Kidney Trials Network, Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia.
Department of Renal Medicine, Tan Tock Seng Hospital, Singapore, Singapore.

Yeoungjee Cho (Y)

Department of Nephrology, Princess Alexandra Hospital, Brisbane, QLD, Australia.
Australasian Kidney Trials Network, Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia.

Kevan R Polkinghorne (KR)

Department of Nephrology, Monash Medical Centre, Melbourne, VIC, Australia.
Department of Medicine, Monash University, Melbourne, VIC, Australia.
School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.

Peta-Anne Paul-Brent (PA)

Australasian Kidney Trials Network, Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia.

Lai-Seong Hooi (LS)

Haemodialysis Unit, Department of Medicine, Hospital Sultanah Aminah, Johor Bahru, Malaysia.

Loke-Meng Ong (LM)

Department of Nephrology, Penang Hospital, George Town, Malaysia.

Trevor A Mori (TA)

Medical School, University of Western Australia, Perth, WA, Australia.

Sunil V Badve (SV)

Australasian Kidney Trials Network, Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia.
Department of Nephrology, St George Hospital, Sydney, NSW, Australia.
The George Institute for Global Health, Sydney, NSW, Australia.

Alan Cass (A)

Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia.

Peter G Kerr (PG)

Department of Nephrology, Monash Medical Centre, Melbourne, VIC, Australia.
Department of Medicine, Monash University, Melbourne, VIC, Australia.

David Voss (D)

Middlemore Renal Services, Middlemore Hospital, Auckland, New Zealand.

Carmel M Hawley (CM)

Department of Nephrology, Princess Alexandra Hospital, Brisbane, QLD, Australia.
Australasian Kidney Trials Network, Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia.
Translational Research Institute, Brisbane, QLD, Australia.

David W Johnson (DW)

Department of Nephrology, Princess Alexandra Hospital, Brisbane, QLD, Australia.
Australasian Kidney Trials Network, Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia.
Translational Research Institute, Brisbane, QLD, Australia.

Ashley B Irish (AB)

Medical School, University of Western Australia, Perth, WA, Australia.
Department of Nephrology, Fiona Stanley Hospital, Perth, WA, Australia.

Andrea K Viecelli (AK)

Department of Nephrology, Princess Alexandra Hospital, Brisbane, QLD, Australia.
Australasian Kidney Trials Network, Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia.

Classifications MeSH