Optimizing AVF creation prior to dialysis start: the role of predialysis renal replacement therapy choices

Research by: Jennifer Hanko(1,2), Alexandra Romann(3), Paul Taylor(1), Michael Copland(1) and Monica Beaulieu(1,3) of (1) the Division of Nephrology, The University of British Columbia, Vancouver, British Columbia, Canada, (2) Regional Nephrology Unit, Belfast City Hospital, Belfast, UK and (3) BC Provincial Renal Agency, British Columbia, Canada.

Journal: Nephrology Dialysis Transplantation

This interesting study of BC patients examined all patients starting dialysis over a two-year period to explore the role of pre-dialysis modality choice on AVF creation rates prior to dialysis start. The authors demonstrated nearly half of all dialysis starts did not have a prior modality choice understandably leading to lower AVF creation rates. Additionally, of those who did choose PD first the presence of cardiovascular disease and lower serum albumin levels correlated with starting HD instead and consequently lower AVF creation rates before dialysis start. This study informs future research to identify factors that impact on patient modality selection to better guide predialysis education and modality choice and optimize most appropriate modality selection and access creation.

Optimizing AVF creation prior to dialysis start: the role of predialysis renal replacement therapy choices (PDF)