The impact of extended-hours home hemodialysis and buttonhole cannulation technique on hospitalization rates for septic events related to dialysis access

Van Eps, CL, Jones, M, Ng, T, Johnson, DW, Campbell, SB, Isbel, NM, Mudge, DW, Beller, E and Hawley, CM (2010) The impact of extended-hours home hemodialysis and buttonhole cannulation technique on hospitalization rates for septic events related to dialysis access. Hemodialysis International, 14 4: 451-463. doi:10.1111/j.1542-4758.2010.00463.x


Author Van Eps, CL
Jones, M
Ng, T
Johnson, DW
Campbell, SB
Isbel, NM
Mudge, DW
Beller, E
Hawley, CM
Title The impact of extended-hours home hemodialysis and buttonhole cannulation technique on hospitalization rates for septic events related to dialysis access
Journal name Hemodialysis International   Check publisher's open access policy
ISSN 1492-7535
1542-4758
Publication date 2010-10
Sub-type Article (original research)
DOI 10.1111/j.1542-4758.2010.00463.x
Volume 14
Issue 4
Start page 451
End page 463
Total pages 13
Place of publication Hoboken, NJ, United States
Publisher Wiley-Blackwell Publishing
Collection year 2011
Language eng
Formatted abstract
Few studies adequately document adverse events in patients receiving long, slow, and overnight hemodialysis (NHD). Concerns about high rates of dialysis access complications have been raised. This is an observational cohort study comparing hospital admission rates for vascular access complications between alternate nightly NHD (n=63) and conventional hemodialysis (n=172) patients established on chronic hemodialysis for at least 3 months. Overall, hospital admission rates and hospital admission rates for cardiac and all infective events are also reported. The NHD cohort was younger and less likely to be female, diabetic, or have ischemic heart disease than the conventional hemodialysis cohort. When NHD and buttonhole cannulation technique were used simultaneously, there was a demonstrated increased risk of septic dialysis access events: incidence rate ratio 3.0 (95% confidence interval 1.04-8.66) (P=0.04). The majority of blood culture isolates in NHD patients were gram-positive organisms, particularly Staphylococcus aureus. Alternate nightly NHD did not significantly change total hospital admissions or hospital admissions for indications other than dialysis access complications, compared with conventional hemodialysis. Our data suggest that buttonhole cannulation technique should be used with caution in patients performing extended-hours hemodialysis as this combination appears to increase the risk of septic access complications. Randomized-controlled trials are needed to confirm these findings. © 2010 The Authors. Hemodialysis International © 2010 International Society for Hemodialysis.
Keyword Buttonhole cannulation
Cardiovascular disease
Complications
Hospitalization
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2011 Collection
School of Medicine Publications
 
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Created: Sun, 07 Nov 2010, 00:10:59 EST