Risk of Complications and Survival of Patients Dialyzed with Permanent Catheters
Abstract
:1. Introduction
2. Materials and Methods
2.1. Statistical Methods
2.2. Ethical Statement
3. Results
4. Discussion
5. Study Limitations
6. Conclusions
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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All Patients | Women | Men | p-Value | |
---|---|---|---|---|
Number of patients (n, %) | 398 (100%) | 204 (51.25%) | 194 (48.75%) | NS |
Age (years, SD) | 68.73 ± 13.26 | 69.50 ± 13.22 | 67.89 ± 13.28 | NS |
The number of catheters inserted after dysfunction of previously formed dialysis shunt (n, %) | 129 (32.41) | 70 (34.31) | 59 (30.31) | NS |
The number of patients with one catheter (n, %) | 322 (80.90%) | 160 (78.43%) | 162 (83.51%) | NS |
The number of patients requiring one catheter replacement (n, %) | 58 (14.57%) | 37 (18.14%) | 21 (10.82%) | <0.1 |
The number of patients requiring two or more catheter replacements (n, %) | 18 (4.52%) | 7 (3.33%) | 11 (5.67%) | NS |
Time from first implantation of the catheter to the end of the study (days, SD) | 505.2 ± 428.3 | 508.9 ± 424.8 | 501.18 ± 433.0 | NS |
The mean time of catheter functioning (days, SD) | 435.7 ± 398.2 | 439.7 ± 404.6 | 431.54 ± 392.4 | NS |
The number of catheters replaced due to infection (n, %) | 10 (2.51) | 6 (2.94) | 4 (2.06) | NS |
Generalized atherosclerosis (n, %) 1 | 108 (27.14%) | 51 (25.00%) | 57 (23.98%) | NS |
Thrombotic catheter complications (n, %) | 66 (16.58%) | 38 (18.63%) | 28 (14.43%) | NS |
Diabetes (n, %) | 73 (18.34%) | 32 (15.69%) | 41 (21.13%) | NS |
Coronary artery disease (n, %) | 44 (11.06%) | 23 (11.27%) | 21 (10.82%) | NS |
Hypertension (n, %) | 109 (27.39%) | 53 (25.98%) | 56 (28.87%) | NS |
Heart failure III-IV acc. to NYHA (n, %) | 78 (19.60%) | 35 (17.16%) | 43 (22.16%) | NS |
Stroke in the history (n, %) | 4 (1.01%) | 3 (1.47%) | 1 (0.52%) | NS |
Chronic atrial fibrillation (n, %) | 12 (3.02%) | 7 (3.43%) | 5 (2.58%) | NS |
Neoplastic disease (n, %) | 78 (19.60%) | 35 (17.16%) | 43 (22.16%) | NS |
Other diseases (n, %) 2 | 87 (21.86%) | 41 (20.60%) | 46 (23.12%) | NS |
The number of all local and generalized infectious complications (n, %) | 92 (23.12%) | 36 (17.65%) | 56 (28.87%) | p < 0.05 |
The number of patients with local and generalized infectious complications (n, %) | 65 (16.33%) | 29 (14.22%) | 36 (18.56%) | NS |
Decease (n, %) | 199 (50.00%) | 103 (50.49%) | 96 (49.48%) | NS |
Patients with a Permanent Catheter Implanted after Dysfunction of a Previously Created Dialysis Fistula | Patients with a Permanent Catheter Implanted as the First Access | p-Value | |
---|---|---|---|
Number of patients (n, %) | 129 (32.41) | 269 (67.59) | |
Age (years, SD) | 66.202 ± 11.799 | 69.944 ± 13.765 | <0.001 |
Female (n, %) | 70 (54.26) | 134 (49.81) | NS |
Time from the first catheter implantation to the end of the follow-up (days, SD) | 565.248 ± 409.284 | 476.342 ± 434.248 | <0.001 |
Mean time of catheter functioning (days, SD) | 449.721 ± 353.274 | 429.037 ± 418.505 | NS |
The number of patients with one catheter (n, %) | 92 (71.32) | 230 (85.50) | 0.001 |
The number of patients requiring one catheter replacement (n, %) | 26 (20.16) | 32 (11.90) | 0.042 |
The number of patients requiring two or more catheter replacements (n, %) | 11 (8.53) | 7 (2.60) | 0,016 |
Thrombotic catheter complications (n, %) | 30 (23.26) | 36 (13.38) | 0.020 |
Diabetes (n, %) | 19 (14.73) | 54 (20.07) | 0.001 |
Generalized atherosclerosis (n, %) | 26 (20,16) | 82 (30,48) | 0,041 |
Coronary artery disease (n, %) | 12 (9.30) | 32 (11.90) | NS |
Hypertension (n, %) | 30 (23.26) | 79 (29.37) | NS |
Heart failure III-IV acc. to NYHA (n, %) | 27 (20.93) | 51 (18.96) | NS |
Stroke in the history (n, %) | 2 (1.55) | 2 (0.74) | NS |
Atrial fibrillation (n, %) | 3 (2.33) | 9 (3.35) | NS |
Neoplastic disease (n, %) | 17 (13.18) | 61 (22.68) | 0.036 |
The number of all local and generalized infectious complications (n, %) | 34 (26.36) | 58 (21.56) | NS |
The number of patients with local and generalized infectious complications (n, %) | 26 (20.16) | 39 (14.49) | NS |
Decease (n, %) | 56 (43.41) | 143 (53.16) | NS (0.087) |
Univariate Logistic Regression | |||
Parameter | HR | 95% CI | p-Value |
Patient’s age | 1.021 | 1.005–1038 | 0.009 |
A disease of atherosclerotic etiology (yes/no) 1 | 1.737 | 1.049–2.875 | 0.031 |
Diabetes | 1.454 | 0.820–2.578 | NS |
Neoplastic disease | 1.932 | 1.075–3.473 | 0.027 |
Other diseases 2 | 1.672 | 0.969–2.885 | NS (0.064) |
Heart failure III-IV according to NYHA classification | 0.884 | 0.523–1.493 | NS |
Multivariate Logistic Regression | |||
Patient’s age | 1.017 | 0.999–1.036 | NS (0.060) |
A disease of atherosclerotic etiology 1 (yes/no) | 1.278 | 0.722–2.263 | NS |
Neoplastic disease | 1.728 | 0.950–3.143 | NS (0.073) |
Other diseases 2 | 1.531 | 0.868–2.700 | NS |
Study Group | Decease | Living Patients | p-Value | |
---|---|---|---|---|
The number of patients (n) | 398 | 199 | 199 | |
Sex (women) (n, %) | 204 (51.26) | 103 (51.76) | 101 (50.75) | NS |
Patient’s age (years ± SD) | 68.88 ± 13.29 | 72.12 ± 11.65 | 67.18 ± 13.64 | <0.001 |
Presence of an earlier dialysis fistula (n, %) | 129 (32.41%) | 56 (28.15%) | 73 (36.68%) | NS (0.086) |
The number of patients with one catheter (n, %) | 322 (80.90%) | 163 (81.91%) | 159 (79.90%) | NS |
The number of patients requiring one catheter replacement (n, %) | 58 (14.57%) | 27 (13.57%) | 31 (15.58%) | NS |
The number of patients with two or more catheter replacements (n, %) | 18 (4.52%) | 9 (4.52%) | 9 (4.52%) | NS |
The number of catheters replaced due to infection (n, %) | 10 (2.51) | 5 (2.51%) | 5 (2.51%) | NS |
The number of catheters replaced due to dysfunction (n, %) | 66 (16.58) | 33 (16.58%) | 33 (16.58%) | NS |
Time from the first catheter implantation to the end of the study (days, SD) | 505.2 ± 428.3 | 317.0 ± 342.7 | 693.3 ± 423.2 | <0.001 |
Mean time of catheter functioning (days, SD) | 435.7 ± 398.2 | 256.6 ± 270.8 | 614.9 ± 424.4 | <0.001 |
Thrombotic catheter complications (n, %) | 66 (16.58%) | 33 (16.58%) | 33 (16.58%) | NS |
Infectious complications (n,%) | 65 (16.33%) | 35 (17.59%) | 30 (15.08%) | NS |
Diabetes mellitus (n, %) | 58 (14.57%) | 28 (14.07%) | 30 (15.08%) | NS |
Generalized atherosclerosis (n, %) | 108 (27.14%) | 67 (33.67%) | 41 (20.60%) | <0.01 |
Coronary artery disease (n, %) | 44 (11.06%) | 22 (11.06%) | 22 (11.06%) | NS |
Hypertension (n, %) | 109 (27.39%) | 56 (28.14%) | 53 (26.63%) | NS |
Atrial fibrillation (n, %) | 12 (3.02%) | 6 (3.02%) | 6 (3.02%) | NS |
Heart failure II/IV according to NYHA classification (n, %) | 78 (19.60%) | 43 (21.61%) | 35 (17.59%) | NS |
Stroke in the history (n, %) | 4 (1.01%) | 3 (1.51%) | 1 (0.50%) | NS |
Neoplastic disease (n, %) | 78 (19.60%) | 36 (18.09%) | 42 (21.11%) | NS |
Decease Risk Cox-Univariate | HR | 95% CI | p-Value |
Patient’s age | 1.035 | 1.023–1.049 | 0.000 |
Generalized atherosclerosis | 1.662 | 1.238–2.232 | 0.000 |
Decease Risk Cox-Bivariate | HR | 95% CI | p-Value |
Patient’s age | 1.034 | 1.020–1.050 | 0.000 |
Generalized atherosclerosis | 1.062 | 0.752–1.500 | NS |
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Szarnecka-Sojda, A.; Jacheć, W.; Polewczyk, M.; Łętek, A.; Miszczuk, J.; Polewczyk, A. Risk of Complications and Survival of Patients Dialyzed with Permanent Catheters. Medicina 2020, 56, 2. https://doi.org/10.3390/medicina56010002
Szarnecka-Sojda A, Jacheć W, Polewczyk M, Łętek A, Miszczuk J, Polewczyk A. Risk of Complications and Survival of Patients Dialyzed with Permanent Catheters. Medicina. 2020; 56(1):2. https://doi.org/10.3390/medicina56010002
Chicago/Turabian StyleSzarnecka-Sojda, Anna, Wojciech Jacheć, Maciej Polewczyk, Agnieszka Łętek, Jarosław Miszczuk, and Anna Polewczyk. 2020. "Risk of Complications and Survival of Patients Dialyzed with Permanent Catheters" Medicina 56, no. 1: 2. https://doi.org/10.3390/medicina56010002