Arteriovenous access creation defers XXXX initiation.

@entity1 @entity9012 @entity102
AIMS: This study evaluated whether arteriovenous access ( @entity9012 ) creation before hemodialysis might affect the rate of decline of renal function. METHODS: This was a retrospective, case-control study comparing two groups of 80 @entity1 each. The @entity9012 group underwent @entity9012 creation more than 2 months before initiation of @entity102 ( @entity102 ). The catheter group (i.e., the control group) commenced @entity102 through a temporary catheter. The catheter group @entity1 were matched with @entity9012 group @entity1 in terms of age, gender, nature of underlying disease, and rate of decline in estimated glomerular filtration rate (eGFR) before @entity9012 creation. The zero point (Z-point) was defined as the date of @entity9012 creation for @entity9012 @entity1 , or the date on which the same eGFR was attained by each catheter group @entity1 compared with a matched @entity9012 @entity1 . Time-to-dialysis was defined as the interval from the Z-point to the date of initiation of dialysis. The rates of change in eGFR before and after the Z-point were also measured. RESULTS: The @entity9012 and catheter groups were similar in terms of baseline characteristics. The Z-point eGFR (ml/min/1.73 m2) was 11.4  3.1 in the @entity9012 group and 11.3  3.2 in the catheter group. The eGFR at the time of dialysis was 6.4  2.0 in the @entity9012 group and 6.1  1.9 in the catheter group. The mean and median dialysis-free time was longer in the @entity9012 than in the catheter group (14.2  9.4 vs. 5.9  4.1 months, 13.1 (3-41) vs. 5.0 (2-17) months, p<0.001). Multivariate proportional Cox's hazard modeling showed that the @entity9012 group and the Z-point eGFR were each independent predictors of the time to initiation of @entity102 . The mean changes in eGFR per month (delta eGFR) before the Z-point were similar for the two groups. For the @entity9012 group, the mean delta eGFR was lower after the Z-point compared to before (-0.63 vs. -0.21 ml/min/1.73 m2, p=0.002). For the catheter group, the mean delta eGFR was similar before and after the Z-point (-0.63 vs. -0.67 ml/min/1.73 m2). The mean delta eGFR after the Z-point was less in the @entity9012 group compared to the catheter group (-0.67 vs. -0.21 ml/min/1.73 m2, p=0.002). CONCLUSION: In this retrospective observational study, @entity9012 creation appears to retard the rate of decline in eGFR and to defer @entity102 initiation.
