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Studies emphasize need to avoid central venous catheters in patients on hemodialysis

December 27, 2015

Some past studies have shown that patients on PD are at lower risk of death during the first year or two on dialysis, compared to patients on HD. "However, these studies have been heavily criticized for comparing 'apples to oranges,'" says Perl. "Their results may speak more towards the type of patients selected for PD over HD rather than a direct impact of PD versus HD itself on patient survival." He believes the new study provides a more fair, "apples to apples'' comparison of PD patients versus HD patients who have been "optimally prepared" with an AVF/AVG.

The study is limited by the fact it was an observational study, rather than a randomized controlled trial. Information on the type of access for HD use was obtained only at the time of dialysis initiation. Information on follow-up vascular access was not available, which would be useful to understand the contribution of the catheter versus other factors contributing to risk of death. There was no information on the reasons why patients started HD with a central catheter, or on whether they started dialysis in the hospital or as an outpatient.

SOURCE American Society of Nephrology