The Initial Vascular Access Type Contributes to Inflammation in Incident Hemodialysis Patients
Background. The contribution of the hemodialysis (HD) vascular access type to inflammation is unclear. Methods. We conducted a prospective observational study in an incident HD population. C-reactive protein (CRP), interleukin-6 (IL-6), and interferon-γ-induced protein (IP-10) were measured before...
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| Format: | Article |
| Language: | English |
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Wiley
2012-01-01
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| Series: | International Journal of Nephrology |
| Online Access: | http://dx.doi.org/10.1155/2012/917465 |
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| author | Mala Sachdeva Adriana Hung Oleksandr Kovalchuk Markus Bitzer Michele H. Mokrzycki |
| author_facet | Mala Sachdeva Adriana Hung Oleksandr Kovalchuk Markus Bitzer Michele H. Mokrzycki |
| author_sort | Mala Sachdeva |
| collection | DOAJ |
| description | Background. The contribution of the hemodialysis (HD) vascular access type to inflammation is unclear. Methods. We conducted a prospective observational study in an incident HD population. C-reactive protein (CRP), interleukin-6 (IL-6), and interferon-γ-induced protein (IP-10) were measured before and at 6-time points after access placement for 1 year. Results. Sixty-four incident HD patients were included (tunneled catheter (TC), 𝑛=40, arteriovenous fistula (AVF), 𝑛=14, and arteriovenous graft (AVG), 𝑛=10). A mixed effects model was performed to adjust for age, sex, race, coronary artery disease, diabetes mellitus, infections, access thrombosis, initiation of HD, and days after access surgery. In comparison to AVFs, the presence of a TC was associated with significantly higher levels of CRP (𝑃=0.03), IL-6 (𝑃=0.07), and IP-10 (𝑃=0.03). The presence of an AVG was associated with increases in CRP (𝑃=0.01) and IP-10 (𝑃=0.07). Conclusions. Patients who initiate HD with a TC or an AVG have a heightened state of inflammation, which may contribute to the excess 90-day mortality after HD initiation. |
| format | Article |
| id | doaj-art-84b4a673b1fc4bdc953065369da83587 |
| institution | Kabale University |
| issn | 2090-214X 2090-2158 |
| language | English |
| publishDate | 2012-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | International Journal of Nephrology |
| spelling | doaj-art-84b4a673b1fc4bdc953065369da835872025-02-03T01:02:25ZengWileyInternational Journal of Nephrology2090-214X2090-21582012-01-01201210.1155/2012/917465917465The Initial Vascular Access Type Contributes to Inflammation in Incident Hemodialysis PatientsMala Sachdeva0Adriana Hung1Oleksandr Kovalchuk2Markus Bitzer3Michele H. Mokrzycki4Division of Nephrology, Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, 3332 Rochambeau Avenue, Centennial Building Room 423, Bronx, NY 10467, USADivision of Nephrology, Department of Medicine, Vanderbilt University, Nashville, TN 37232, USADivision of Nephrology, Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, 3332 Rochambeau Avenue, Centennial Building Room 423, Bronx, NY 10467, USADivision of Nephrology, Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, 3332 Rochambeau Avenue, Centennial Building Room 423, Bronx, NY 10467, USADivision of Nephrology, Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, 3332 Rochambeau Avenue, Centennial Building Room 423, Bronx, NY 10467, USABackground. The contribution of the hemodialysis (HD) vascular access type to inflammation is unclear. Methods. We conducted a prospective observational study in an incident HD population. C-reactive protein (CRP), interleukin-6 (IL-6), and interferon-γ-induced protein (IP-10) were measured before and at 6-time points after access placement for 1 year. Results. Sixty-four incident HD patients were included (tunneled catheter (TC), 𝑛=40, arteriovenous fistula (AVF), 𝑛=14, and arteriovenous graft (AVG), 𝑛=10). A mixed effects model was performed to adjust for age, sex, race, coronary artery disease, diabetes mellitus, infections, access thrombosis, initiation of HD, and days after access surgery. In comparison to AVFs, the presence of a TC was associated with significantly higher levels of CRP (𝑃=0.03), IL-6 (𝑃=0.07), and IP-10 (𝑃=0.03). The presence of an AVG was associated with increases in CRP (𝑃=0.01) and IP-10 (𝑃=0.07). Conclusions. Patients who initiate HD with a TC or an AVG have a heightened state of inflammation, which may contribute to the excess 90-day mortality after HD initiation.http://dx.doi.org/10.1155/2012/917465 |
| spellingShingle | Mala Sachdeva Adriana Hung Oleksandr Kovalchuk Markus Bitzer Michele H. Mokrzycki The Initial Vascular Access Type Contributes to Inflammation in Incident Hemodialysis Patients International Journal of Nephrology |
| title | The Initial Vascular Access Type Contributes to Inflammation in Incident Hemodialysis Patients |
| title_full | The Initial Vascular Access Type Contributes to Inflammation in Incident Hemodialysis Patients |
| title_fullStr | The Initial Vascular Access Type Contributes to Inflammation in Incident Hemodialysis Patients |
| title_full_unstemmed | The Initial Vascular Access Type Contributes to Inflammation in Incident Hemodialysis Patients |
| title_short | The Initial Vascular Access Type Contributes to Inflammation in Incident Hemodialysis Patients |
| title_sort | initial vascular access type contributes to inflammation in incident hemodialysis patients |
| url | http://dx.doi.org/10.1155/2012/917465 |
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