Hemodialysis Arteriovenous Vascular Access Creation After XXXX .

@entity1 @entity453 @entity8 @entity6
BACKGROUND: Little is known about vascular access in @entity1 starting hemodialysis therapy after @entity8 . STUDY DESIGN: Retrospective cohort study. SETTING _ @entity1 : Adult @entity1 (aged  >= 18 years) who started hemodialysis therapy in Ontario, Canada, from January 1, 2001, through December 31, 2010, after @entity8 . PREDICTOR: @entity1 clinical and demographic characteristics. OUTCOMES: Proportion and timing of arteriovenous (AV) vascular access creation (fistula or graft) 12 months prior and up to 24 months after starting hemodialysis therapy. MEASUREMENTS: Event rates and outcome predictors. RESULTS: Our cohort included 683 @entity1 with a mean age of 48 years and >50% with comorbidity index score  < 3. In the 12 months predialysis and 24 months postdialysis, 16% and 47% of @entity1 had an AV access created, respectively. In the postdialysis period, 13%, 26%, and 38% of @entity1 had an AV access creation at 3, 6, and 12 months, respectively. History of @entity453 , @entity6 , and peritoneal dialysis use prior to transplantation were associated with a lower likelihood of AV access creation. LIMITATIONS: Residual selection bias from unmeasured variables beyond the data elements. CONCLUSIONS: In Ontario, AV access creation, both before and after starting hemodialysis therapy, is low in @entity1 with @entity8 despite their being younger and healthier compared to the overall hemodialysis population. This highlights the need for a predialysis care pathway in the transplantation clinic and an active strategy to identify this @entity1 cohort receiving hemodialysis to align modality and access choices.
