International comparisons of native arteriovenous fistula patency

Arteriovenous fistulae (AVF) are the access of first choice, with AVF use greatly differing across countries. However, AVFs are not suitable for all patients. Thus, to maximize patient outcomes and experiences, the goal is to determine the best access for each person, with the current study designed to further inform this goal by describing: (1) international differences in rates and predictors of how long an AVF remains functional (patency), (2) variation in time until first successful AVF use, and (3) outcomes if a new AVF is not successfully used. These findings highlight the need to reevaluate practices for optimizing achievable AVF outcomes, especially AVF maturation which was considerably greater in Japan. New AVFs that are not successfully used associate with long-term catheter exposure and substantially higher mortality risk. These findings highlight the importance of selecting the best access type for each patient and developing effective clinical pathways for when AVFs fail to mature successfully.

Article Title: International Comparisons of Native Arteriovenous Fistula Patencies and Time to Becoming Catheter-Free: Results from the DOPPS

Authors: Ronald L. Pisoni, PhD, MS, Lindsay Zepel, MS , Junhui Zhao, PhD, Steven Burke, MD, Charmaine E. Lok, MD , Kenneth J. Woodside, MD, Haimanot Wasse, MD, MPH, Hideki Kawanishi, MD, Douglas Schaubel, PhD, Jarcy Zee, PhD, and Bruce M. Robinson, MD, MS, FACP

DOI: 10.1053/j.ajkd.2020.06.020

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