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BMC Nephrology
Published in: BMC Nephrology 1/2018

Open Access 01-12-2018 | Research article

Factors affecting fistula failure in patients on chronic hemodialysis: a population–based case–control study

Authors: Cheng-Chieh Yen, Ching-Fang Tsai, Yueh-Yun Luo, Hsin-Yi Yang, Mei-Yin Liu, Peir-Haur Hung, Yueh-Han Hsu

Published in: BMC Nephrology | Issue 1/2018

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Abstract

Background

With advancement of hemodialysis (HD) technique, late fistula failure (LFF) remains a problem significantly affecting life quality of patients. We attempt to identify factors affecting LFF in patients on chronic HD in Taiwan from the National Health Insurance Research Database.

Methods

This case–control study enrolled patients over 18 years old and who received regular HD for more than 3 months. LFF was defined as the first fistula failure episode beyond 3 months of chronic HD. We analyzed characteristics, comorbidities and medicine and investigated the association factors of LFF by logistic regression model. A trend test was conducted for risk in different provider levels. Sensitivity tests were conducted to test consistency.

Results

Of 1558 patients recruited, 772 (49.6%) were identified as LFF cases and 786 were identified as controls. The data showed that patients with diabetes mellitus (DM) had 42% increased rate of LFF. Patients receiving more than 10 HD sessions per month had a 90% increased rate of LFF; patients receiving chronic HD in private clinics had a 49% reduction rate of LFF. There were no significant differences in age, dialysis frequency, and comorbidities among different provider levels. There was a significant trend of risk reduction of the event from medical centers, regional hospitals, district hospitals, to private clinics. The sensitivity tests revealed similar results.

Conclusions

The factors associated with LFF include DM and receiving more HD sessions; on the contrary, receiving HD in private clinics is associated with less risk of LFF.
Appendix
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Metadata
Title
Factors affecting fistula failure in patients on chronic hemodialysis: a population–based case–control study
Authors
Cheng-Chieh Yen
Ching-Fang Tsai
Yueh-Yun Luo
Hsin-Yi Yang
Mei-Yin Liu
Peir-Haur Hung
Yueh-Han Hsu
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Nephrology / Issue 1/2018
Electronic ISSN: 1471-2369
DOI
https://doi.org/10.1186/s12882-018-1010-6

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