Racial, ethnic differences seen in arteriovenous access after hemodialysis initiation
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Key takeaways:
- Arteriovenous access use within 1 year after hemodialysis initiation increased in all racial/ethnic groups.
- Differences in arteriovenous access use and location persisted.
PHILADELPHIA — Racial and ethnic differences exist in arteriovenous access use in patients 1 year after hemodialysis initiation, according to data presented at ASN Kidney Week.
“Vascular access is a lifeline for patients on hemodialysis,” Melandrea L. Worsley, MD, a nephrologist at the Baylor College of Medicine in Houston, told Healio. “Although there are racial and ethnic differences in arteriovenous vascular access use at the time of dialysis initiation, less is known about these differences in vascular access creation after dialysis initiation with a central venous catheter.”
Researchers gathered data from a large dialysis organization and identified 198,186 patients who started hemodialysis with a central venous catheter (CVC) from 2006 to 2016 and remained on dialysis for at least 1 year. Overall, 34% of patients were Black, 16% were Hispanic, 43% were white and 7% were categorized as being of other races/ethnicities. Use of an arteriovenous (AV) access within 1 year after starting hemodialysis with a CVC was plotted by calendar year.
According to the findings, AV access use within 1 year after hemodialysis initiation increased in all racial/ethnic groups during the study. However, racial and ethnic differences in AV access use and location of the access persisted, Woosley said.
Researchers also noted that Black patients had similar odds of using an AV access within 1 year vs. white patients. Patients of other races were consistently more likely to use an AV access compared with white patients, while Hispanic patients were at times more likely to use the access than white patients, data showed.
Black patients were less likely to use an AV access placed in the preferred location in the lower arm than the other groups.
“Further research is warranted to identify causative factors contributing to the racial and ethnic differences in AV access use, both at the time of HD initiation and 1 year after HD initiation with a CVC,” Worsley and researchers wrote.
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Worsley ML, et al. SA-PO047. Presented at: ASN Kidney Week; Nov. 2-5, 2023; Philadelphia.
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