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Excessive Access Cannulation Site Bleeding Predicts Long‐Term All‐Cause Mortality in Chronic Hemodialysis Patients
Author(s) -
Tsai WanChuan,
Chen HungYuan,
Lin ChiLin,
Huang ShuChen,
Hsu ShihPing,
Pai MeiFen,
Peng YuSen,
Chiu YenLing
Publication year - 2015
Publication title -
therapeutic apheresis and dialysis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.415
H-Index - 53
eISSN - 1744-9987
pISSN - 1744-9979
DOI - 10.1111/1744-9987.12304
Subject(s) - medicine , hemodialysis , proportional hazards model , dialysis , anemia , population , hazard ratio , observational study , cause of death , surgery , confidence interval , disease , environmental health
Our group has previously reported that excessive vascular access bleeding during dialysis treatment in stable hemodialysis ( HD ) patients was associated with anemia and may indicate poorer health. The association between excessive blood loss from access cannulation site and clinical outcomes was unknown. We hypothesized that excessive access bleeding may have an impact on all‐cause and cardiovascular ( CV ) mortality in this population. We prospectively conducted an observational, longitudinal study of 360 HD patients. Excessive access bleeding was defined as at least an occurrence of blood loss greater than 4 mL per HD session during a study period of one month. During a median follow‐up of 83 months, all‐cause mortality and CV mortality were registered. Outcomes were analyzed by K aplan– M eier and Cox proportional hazards regression analyses. A total of 118 (32.8%) participants died and 54 of these were from CV death. Using a multivariate Cox proportional hazards regression, access bleeding was found to be an independent predictor of all‐cause mortality (HR 1.67, 95% CI 0.96–2.91, P = 0.070) but not for CV death ( HR 1.53, 95% CI 0.88–2.68, P = 0.135). Our study identified that excessive access cannulation site bleeding could be a novel marker for increased risk of death in HD patients.