Use of vascular access for haemodialysis in Europe: a report from the ERA-EDTA Registry

Marlies Noordzij (Lead / Corresponding author), Kitty J. Jager, Sabine N. van der Veer, Reinhard Kramar, Frederic Collart, James G. Heaf, Olivera Stojceva-Taneva, Torbjørn Leivestad, Jadranka Buturovic-Ponikvar, Manuel Benítez Sánchez, Fransesc Moreso, Karl G. Prütz, Alison Severn, Christoph Wanner, Raymond Vanholder, Pietro Ravani

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    Abstract

    Background Although arteriovenous fistulas (AVFs) are actively promoted, their use at the start of haemodialysis (HD) seems to be decreasing worldwide. In this paper, we describe recent trends in incidence and prevalence of vascular access types in Europe from 2005 to 2009 and their relationship with patient characteristics and survival.

    Methods Ten European renal registries participating in the ERA-EDTA Registry provided data on incidence (n = 13 044) and/or prevalence (n = 75 715) of vascular access types. We used logistic regression to assess which factors influence the likelihood to be treated with an AVF rather than another type.

    Results The use of AVFs at the start of HD showed a significant decreasing trend from 42% in 2005 to 32% in 2009 (P < 0.0001), while the use of central venous catheters (CVCs) increased from 58 to 68% (P < 0.0001). A similar evolution pattern was observed for the prevalence; use of AVFs decreased from 66 to 62% and use of CVCs increased from 28 to 32%. There was a large international variation in the use of the different vascular access types. Female patients [adjusted odds ratio: 0.84, 95% confidence interval (CI): 0.78–0.90] and those =80 years (0.77, 95% CI: 0.67–0.90) were least likely to start HD with an AVF.

    Conclusion In Europe, there is a decreasing trend in the use of AVFs and an increasing trend in the use of CVCs at the start and after the start of HD. We cannot explain all between-country variations we found, and more research is needed to clarify how healthcare around vascular access is organized in Europe.
    Original languageEnglish
    Pages (from-to)1956-1964
    Number of pages9
    JournalNephrology Dialysis Transplantation
    Volume29
    Issue number10
    DOIs
    Publication statusPublished - Oct 2014

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