Vascular Access Facts
By Susan Eymann, MS
| 30 Dec 2019
(Gleaned from the 2018 USRDS Annual Data Report: Volume II: Chapter 3)
- In 2016, 80% of patients were using a catheter at hemodialysis (HD) initiation.
- At 90 days after the initiation of HD, 69% of patients were still using catheters.
- Arteriovenous (AV) fistula use at HD initiation rose from 12% to 17% between 2005 and 2016.
- The percentage of patients using an AV fistula or with a maturing AV fistula at HD initiation increased from 28.9% to 33% over the same period.
- Seventeen percent of patients used an AV fistula exclusively at dialysis initiation. This increased to 64% by the end of one year on HD, and to 71% by the end of two years.
- The proportion of patients with an AV graft for vascular access was 3% at HD initiation, 15% at one year after initiation, and 17% at two years.
- At one year after HD initiation, 79% of patients were using either an AV fistula or AV graft without the presence of a catheter. By two years, this number rose to 88%.
- By May 2017, 62.8% of prevalent dialysis patients in the U.S. were using an AV fistula.
- Of AV fistulas placed between June 2014 and May 2016, 39% failed to mature sufficiently for use in dialysis. Of those that did mature, the median time to first use was 108 days.
- Patient demographic characteristics appear to contribute to success with AV fistula; at younger ages, the percent of AV fistulas that successfully mature is higher and the median time to first use is somewhat shorter. Males had a higher AV fistula maturation rate compared to females, as well as shorter time to first use. Blacks experienced the highest AV fistula maturation failure rates, compared to other races.