{"doi":"10.1093/ndt/gfad251","title":"Arteriovenous access creation and hazards of hospitalization and death in patients starting hemodialysis","abstract":"<jats:title>ABSTRACT</jats:title>\n               <jats:sec>\n                  <jats:title>Background</jats:title>\n                  <jats:p>Recent evidence suggests an overestimation of the benefits associated with arteriovenous (AV) fistula versus graft in certain populations. We assessed hazards of all-cause and cause-specific hospitalization and death associated with AV access type in patients who started hemodialysis with a catheter in France, overall and by subgroups of age, sex and comorbidities.</jats:p>\n               </jats:sec>\n               <jats:sec>\n                  <jats:title>Methods</jats:title>\n                  <jats:p>We performed a target trial emulation including patients who initiated hemodialysis with a catheter from 2010 through 2018 and were followed by the REIN Registry. We identified first-created fistula or graft through the French national health-administrative database. We used joint frailty models to deal with recurrent hospitalizations and potential informative censoring by death, and inverse probability weighting to account for confounding.</jats:p>\n               </jats:sec>\n               <jats:sec>\n                  <jats:title>Results</jats:title>\n                  <jats:p>From the 18 800 patients included (mean age 68 ± 15 years, 35% women), 5% underwent AV graft creation first. The weighted hazard ratio (wHR) of all-cause hospitalization associated with graft was 1.08 [95% confidence interval (CI) 1.02 to 1.15], that of vascular access–related hospitalization was 1.43 (95% CI 1.32 to 1.55), and those of cardiovascular- and infection-related hospitalizations were 1.14 (95% CI 1.03 to 1.26) and 1.11 (95% CI 0.97 to 1.28), respectively. Results were consistent for most subgroups, except that the highest hazard of all-cause, cardiovascular- and infection-related hospitalizations with graft was blunted in patients with comorbidities (i.e. diabetes, wHR 1.01, 95% CI 0.93 to 1.10; 1.10, 95% CI 0.96 to 1.26; and 0.94, 95% CI 0.78 to 1.12, respectively).</jats:p>\n               </jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions</jats:title>\n                  <jats:p>In patients starting hemodialysis with a catheter, AV graft creation is associated with increased hazard of vascular access–related hospitalizations compared with fistula. This may not be the case for death or other causes of hospitalization.</jats:p>\n               </jats:sec>","journal":"Nephrology Dialysis Transplantation","year":2024,"id":652151,"datarank":0.16479184330021646,"base_score":1.0986122886681096,"endowment":1.0986122886681096,"self_citation_contribution":0.16479184330021646,"citation_network_contribution":0.0,"self_endowment_contribution":0.16479184330021646,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":2,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":null,"is_data_producer":false,"deposit_databanks":null,"is_oa":false,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":null,"fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1701095,"name":"Mathilde Prezelin-Reydit","orcid":"0000-0001-8302-7783","position":1,"is_corresponding":false},{"id":1701097,"name":"Jerome Harambat","orcid":null,"position":2,"is_corresponding":false},{"id":123219,"name":"Cécile Couchoud","orcid":"0000-0002-9273-660X","position":3,"is_corresponding":false},{"id":1701100,"name":"Florence Glaudet","orcid":null,"position":4,"is_corresponding":false},{"id":1394333,"name":"Christian Combe","orcid":"0000-0002-0360-573X","position":5,"is_corresponding":false},{"id":1272352,"name":"Virginie Rondeau","orcid":"0000-0001-7109-4831","position":6,"is_corresponding":false},{"id":728732,"name":"Karen Leffondré","orcid":"0000-0002-1269-8069","position":7,"is_corresponding":false},{"id":1014453,"name":"Natália Alencar de Pinho","orcid":"0000-0002-0438-6487","position":0,"is_corresponding":false}],"reference_count":0,"raw_metadata":{"has_enrichment":true,"resolved":true,"title":"Arteriovenous access creation and hazards of hospitalization and death in patients starting hemodialysis","abstract":"<jats:title>ABSTRACT</jats:title>\n               <jats:sec>\n                  <jats:title>Background</jats:title>\n                  <jats:p>Recent evidence suggests an overestimation of the benefits associated with arteriovenous (AV) fistula versus graft in certain populations. We assessed hazards of all-cause and cause-specific hospitalization and death associated with AV access type in patients who started hemodialysis with a catheter in France, overall and by subgroups of age, sex and comorbidities.</jats:p>\n               </jats:sec>\n               <jats:sec>\n                  <jats:title>Methods</jats:title>\n                  <jats:p>We performed a target trial emulation including patients who initiated hemodialysis with a catheter from 2010 through 2018 and were followed by the REIN Registry. We identified first-created fistula or graft through the French national health-administrative database. We used joint frailty models to deal with recurrent hospitalizations and potential informative censoring by death, and inverse probability weighting to account for confounding.</jats:p>\n               </jats:sec>\n               <jats:sec>\n                  <jats:title>Results</jats:title>\n                  <jats:p>From the 18 800 patients included (mean age 68 ± 15 years, 35% women), 5% underwent AV graft creation first. The weighted hazard ratio (wHR) of all-cause hospitalization associated with graft was 1.08 [95% confidence interval (CI) 1.02 to 1.15], that of vascular access–related hospitalization was 1.43 (95% CI 1.32 to 1.55), and those of cardiovascular- and infection-related hospitalizations were 1.14 (95% CI 1.03 to 1.26) and 1.11 (95% CI 0.97 to 1.28), respectively. Results were consistent for most subgroups, except that the highest hazard of all-cause, cardiovascular- and infection-related hospitalizations with graft was blunted in patients with comorbidities (i.e. diabetes, wHR 1.01, 95% CI 0.93 to 1.10; 1.10, 95% CI 0.96 to 1.26; and 0.94, 95% CI 0.78 to 1.12, respectively).</jats:p>\n               </jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions</jats:title>\n                  <jats:p>In patients starting hemodialysis with a catheter, AV graft creation is associated with increased hazard of vascular access–related hospitalizations compared with fistula. This may not be the case for death or other causes of hospitalization.</jats:p>\n               </jats:sec>","is_dataset_classified":null,"base_score":1.0986122886681096,"endowment":1.0986122886681096,"datacite_reuse_total":0,"file_count":0,"downloads":0,"views":0,"has_version_chain":false,"is_dataset":false,"is_oa":false,"pmid":"38012126","pmcid":null,"openalex_id":"https://openalex.org/W4389068215","authors":[],"funders":[{"funder_name":"French Biomedicine Agency","grant_id":"19REIN001","title":null}],"total_grants":1,"fwci":0.5939,"citation_percentile":0.69601197,"influential_citations":0,"citation_trend":[{"year":2024,"count":1},{"year":2025,"count":1}],"oa_status":"bronze","license":"https://academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model","oa_locations":[{"url":"https://academic.oup.com/ndt/advance-article-pdf/doi/10.1093/ndt/gfad251/55976761/gfad251.pdf","host_type":"journal"},{"url":"https://academic.oup.com/ndt/advance-article-pdf/doi/10.1093/ndt/gfad251/55976761/gfad251.pdf","host_type":"publisher"},{"url":"https://academic.oup.com/ndt/article-pdf/39/6/978/58008384/gfad251.pdf","host_type":"publisher"},{"url":"https://doi.org/10.1093/ndt/gfad251","host_type":"journal"},{"url":"https://pubmed.ncbi.nlm.nih.gov/38012126","host_type":"repository"},{"url":"https://hal.science/hal-04380322","host_type":"repository"},{"url":"https://oskar-bordeaux.fr/handle/20.500.12278/186945","host_type":"repository"},{"url":"https://oskar-bordeaux.fr/handle/20.500.12278/205730","host_type":""}],"fields_of_study":["Central Venous Catheters and Hemodialysis","Dialysis and Renal Disease Management","Diagnosis and Treatment of Venous Diseases","Humans","Renal Dialysis","Female","Male","Aged","Hospitalization","Arteriovenous Shunt, Surgical","Kidney Failure, Chronic","France","Registries","Middle Aged","Survival Rate","Cause of Death"],"mesh_terms":["Aged","Arteriovenous Shunt, Surgical","Cause of Death","Female","France","Renal Dialysis","Hospitalization","Humans","Kidney Failure, Chronic","Male","Middle Aged","Registries","Survival Rate"],"keywords":["Medicine","Hemodialysis","Hazard ratio","Proportional hazards model","Confounding","Diabetes mellitus","Internal medicine","Cause of death","Arteriovenous fistula","Surgery","Confidence interval","arteriovenous graft","hospitalization","outcomes","vascular access"],"sdg_mappings":[{"sdg_number":0,"sdg_label":"Good health and well-being"}],"linked_datasets":[],"clinical_trials":[],"software_tools":[],"database_accessions":[],"source":"live","citation_network_status":"fetched"},"created_at":"2026-08-10T12:06:30.635673Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}