Outcomes of temporary vascular access and factors influencing delayed arteriovenous fistula creation among intermittent hemodialysis patients: a study in hospital Universiti Sains Malaysia, Kelantan
Introduction: Haemodialysis is the main modality of Renal Replacement Therapy (RRT) in Malaysia. However, most of the patients are initiated with intermittent haemodialysis via a central venous catheter as their main vascular access before placement of arteriovenous fistula (AVF) or graft (AVG)....
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| Format: | Thesis |
| Language: | English |
| Published: |
2023
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| Subjects: | |
| Online Access: | http://eprints.usm.my/62046/ http://eprints.usm.my/62046/1/Abdul%20Hanan%20Abdullah%20%40%20Mohd%20Baharudin-E.pdf |
| _version_ | 1848884874899881984 |
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| author | Abdullah @ Mohd Baharudin, Abdul Hanan |
| author_facet | Abdullah @ Mohd Baharudin, Abdul Hanan |
| author_sort | Abdullah @ Mohd Baharudin, Abdul Hanan |
| building | USM Institutional Repository |
| collection | Online Access |
| description | Introduction: Haemodialysis is the main modality of Renal Replacement Therapy (RRT)
in Malaysia. However, most of the patients are initiated with intermittent haemodialysis via
a central venous catheter as their main vascular access before placement of arteriovenous
fistula (AVF) or graft (AVG).
Objectives: This study aimed to identify types of vascular access among intermittent
haemodialysis patients, and to determine the proportion of vascular access-related
complications. We also aimed to study the factor that contributed to the delay of AVF
creation at our institution.
Methods: This is a single-centre retrospective, cross-sectional analysis of CKD stage 5
patients who were initiated on intermittent haemodialysis between 1 January 2021 and 31
December 2021. Data were collected from the medical record unit of Hospital Universiti
Sains Malaysia, Kubang Kerian, Kelantan. Demographic data, comorbidities, catheterrelated
complications, associated mortality, and factors of delayed AVF creation were
analyzed using SPSS version 27. The association between types of a catheter with
complication were analyzed by chi-square test. A P-value of less than 0.05 was considered
statistically significant.
Results: A total of 74 patients with intermittent haemodialysis were identified. Of these,
males were 52.7 % and females were 47.3 %. Most patients were of Malay ethnicity with a
mean age of 55 years old. Most of them have comorbidities of hypertension 95.9%, diabetes
79.7 % and ischemic heart diseases 23%. Most of them initiate haemodialysis with an Introduction: Haemodialysis is the main modality of Renal Replacement Therapy (RRT)
in Malaysia. However, most of the patients are initiated with intermittent haemodialysis via
a central venous catheter as their main vascular access before placement of arteriovenous
fistula (AVF) or graft (AVG).
Objectives: This study aimed to identify types of vascular access among intermittent
haemodialysis patients, and to determine the proportion of vascular access-related
complications. We also aimed to study the factor that contributed to the delay of AVF
creation at our institution.
Methods: This is a single-centre retrospective, cross-sectional analysis of CKD stage 5
patients who were initiated on intermittent haemodialysis between 1 January 2021 and 31
December 2021. Data were collected from the medical record unit of Hospital Universiti
Sains Malaysia, Kubang Kerian, Kelantan. Demographic data, comorbidities, catheterrelated
complications, associated mortality, and factors of delayed AVF creation were
analyzed using SPSS version 27. The association between types of a catheter with
complication were analyzed by chi-square test. A P-value of less than 0.05 was considered
statistically significant.
Results: A total of 74 patients with intermittent haemodialysis were identified. Of these,
males were 52.7 % and females were 47.3 %. Most patients were of Malay ethnicity with a
mean age of 55 years old. Most of them have comorbidities of hypertension 95.9%, diabetes
79.7 % and ischemic heart diseases 23%. Most of them initiate haemodialysis with an uncuffed femoral catheter, 93.2% and later, they change to the uncuffed internal jugular
catheter 71.6%. The highest complication seen was central line-associated bloodstream
infections (CLABSI) which were in 17.6% of patients, followed by hematoma in 8.5% of
patients. We found no significant association between the types of haemodialysis catheters
used with their complications. With regards to the delay in AVF creation, the majority of
patients (36.2%) mention dialysis fear as their main concern, followed by small venous
access, 34%. A total of 18 patients died during this study period. The major causes of death
are due to CLABSI (5 patients) and sepsis-not related to catheter insertion (5 patients).
Conclusion: In conclusion, the use of a haemodialysis central venous catheter among
intermittent haemodialysis patients carries a significant risk for catheter-related
complications, particularly infections and bleeding, with a risk of mortality. Early creation
of arteriovenous fistula in pre-dialysis patients is vital in improving the outcomes of the
patients. |
| first_indexed | 2025-11-15T19:13:39Z |
| format | Thesis |
| id | usm-62046 |
| institution | Universiti Sains Malaysia |
| institution_category | Local University |
| language | English |
| last_indexed | 2025-11-15T19:13:39Z |
| publishDate | 2023 |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | usm-620462025-05-25T00:52:35Z http://eprints.usm.my/62046/ Outcomes of temporary vascular access and factors influencing delayed arteriovenous fistula creation among intermittent hemodialysis patients: a study in hospital Universiti Sains Malaysia, Kelantan Abdullah @ Mohd Baharudin, Abdul Hanan R Medicine RC648-665 Diseases of the endocrine glands. Clinical endocrinology Introduction: Haemodialysis is the main modality of Renal Replacement Therapy (RRT) in Malaysia. However, most of the patients are initiated with intermittent haemodialysis via a central venous catheter as their main vascular access before placement of arteriovenous fistula (AVF) or graft (AVG). Objectives: This study aimed to identify types of vascular access among intermittent haemodialysis patients, and to determine the proportion of vascular access-related complications. We also aimed to study the factor that contributed to the delay of AVF creation at our institution. Methods: This is a single-centre retrospective, cross-sectional analysis of CKD stage 5 patients who were initiated on intermittent haemodialysis between 1 January 2021 and 31 December 2021. Data were collected from the medical record unit of Hospital Universiti Sains Malaysia, Kubang Kerian, Kelantan. Demographic data, comorbidities, catheterrelated complications, associated mortality, and factors of delayed AVF creation were analyzed using SPSS version 27. The association between types of a catheter with complication were analyzed by chi-square test. A P-value of less than 0.05 was considered statistically significant. Results: A total of 74 patients with intermittent haemodialysis were identified. Of these, males were 52.7 % and females were 47.3 %. Most patients were of Malay ethnicity with a mean age of 55 years old. Most of them have comorbidities of hypertension 95.9%, diabetes 79.7 % and ischemic heart diseases 23%. Most of them initiate haemodialysis with an Introduction: Haemodialysis is the main modality of Renal Replacement Therapy (RRT) in Malaysia. However, most of the patients are initiated with intermittent haemodialysis via a central venous catheter as their main vascular access before placement of arteriovenous fistula (AVF) or graft (AVG). Objectives: This study aimed to identify types of vascular access among intermittent haemodialysis patients, and to determine the proportion of vascular access-related complications. We also aimed to study the factor that contributed to the delay of AVF creation at our institution. Methods: This is a single-centre retrospective, cross-sectional analysis of CKD stage 5 patients who were initiated on intermittent haemodialysis between 1 January 2021 and 31 December 2021. Data were collected from the medical record unit of Hospital Universiti Sains Malaysia, Kubang Kerian, Kelantan. Demographic data, comorbidities, catheterrelated complications, associated mortality, and factors of delayed AVF creation were analyzed using SPSS version 27. The association between types of a catheter with complication were analyzed by chi-square test. A P-value of less than 0.05 was considered statistically significant. Results: A total of 74 patients with intermittent haemodialysis were identified. Of these, males were 52.7 % and females were 47.3 %. Most patients were of Malay ethnicity with a mean age of 55 years old. Most of them have comorbidities of hypertension 95.9%, diabetes 79.7 % and ischemic heart diseases 23%. Most of them initiate haemodialysis with an uncuffed femoral catheter, 93.2% and later, they change to the uncuffed internal jugular catheter 71.6%. The highest complication seen was central line-associated bloodstream infections (CLABSI) which were in 17.6% of patients, followed by hematoma in 8.5% of patients. We found no significant association between the types of haemodialysis catheters used with their complications. With regards to the delay in AVF creation, the majority of patients (36.2%) mention dialysis fear as their main concern, followed by small venous access, 34%. A total of 18 patients died during this study period. The major causes of death are due to CLABSI (5 patients) and sepsis-not related to catheter insertion (5 patients). Conclusion: In conclusion, the use of a haemodialysis central venous catheter among intermittent haemodialysis patients carries a significant risk for catheter-related complications, particularly infections and bleeding, with a risk of mortality. Early creation of arteriovenous fistula in pre-dialysis patients is vital in improving the outcomes of the patients. 2023 Thesis NonPeerReviewed application/pdf en http://eprints.usm.my/62046/1/Abdul%20Hanan%20Abdullah%20%40%20Mohd%20Baharudin-E.pdf Abdullah @ Mohd Baharudin, Abdul Hanan (2023) Outcomes of temporary vascular access and factors influencing delayed arteriovenous fistula creation among intermittent hemodialysis patients: a study in hospital Universiti Sains Malaysia, Kelantan. Masters thesis, Pusat Pengajian Sains Perubatan. |
| spellingShingle | R Medicine RC648-665 Diseases of the endocrine glands. Clinical endocrinology Abdullah @ Mohd Baharudin, Abdul Hanan Outcomes of temporary vascular access and factors influencing delayed arteriovenous fistula creation among intermittent hemodialysis patients: a study in hospital Universiti Sains Malaysia, Kelantan |
| title | Outcomes of temporary vascular access and
factors influencing delayed arteriovenous
fistula creation among intermittent
hemodialysis patients: a study in hospital
Universiti Sains Malaysia, Kelantan |
| title_full | Outcomes of temporary vascular access and
factors influencing delayed arteriovenous
fistula creation among intermittent
hemodialysis patients: a study in hospital
Universiti Sains Malaysia, Kelantan |
| title_fullStr | Outcomes of temporary vascular access and
factors influencing delayed arteriovenous
fistula creation among intermittent
hemodialysis patients: a study in hospital
Universiti Sains Malaysia, Kelantan |
| title_full_unstemmed | Outcomes of temporary vascular access and
factors influencing delayed arteriovenous
fistula creation among intermittent
hemodialysis patients: a study in hospital
Universiti Sains Malaysia, Kelantan |
| title_short | Outcomes of temporary vascular access and
factors influencing delayed arteriovenous
fistula creation among intermittent
hemodialysis patients: a study in hospital
Universiti Sains Malaysia, Kelantan |
| title_sort | outcomes of temporary vascular access and
factors influencing delayed arteriovenous
fistula creation among intermittent
hemodialysis patients: a study in hospital
universiti sains malaysia, kelantan |
| topic | R Medicine RC648-665 Diseases of the endocrine glands. Clinical endocrinology |
| url | http://eprints.usm.my/62046/ http://eprints.usm.my/62046/1/Abdul%20Hanan%20Abdullah%20%40%20Mohd%20Baharudin-E.pdf |