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Dialysis Knowledge May Be Linked to Vascular Access

Last Updated: April 24, 2009.

Patients who are more knowledgeable about dialysis when they begin hemodialysis may be more likely to use an arteriovenous fistula or graft compared to a catheter, according to research published online ahead of print April 23 in the Clinical Journal of the American Society of Nephrology.

FRIDAY, April 24 (HealthDay News) -- Patients who are more knowledgeable about dialysis when they begin hemodialysis may be more likely to use an arteriovenous fistula (AVF) or graft (AVG) compared to a catheter, according to research published online ahead of print April 23 in the Clinical Journal of the American Society of Nephrology.

Kerri L. Cavanaugh, M.D., of the Vanderbilt University Medical Center in Nashville, Tenn., and colleagues analyzed data from 490 patients whose knowledge about dialysis was assessed with the Chronic Hemodialysis Knowledge Survey at baseline. The primary outcome was type of dialysis access at baseline, three months, and six months. Use of an AVF or AVG is associated with lower mortality than using a catheter for dialysis access.

The researchers found that the people who used a dialysis catheter at initiation compared to an AVF or AVG had lower knowledge scores. Those scoring 20 percentage points higher were 25 percent more likely to use an AVF or AVG upon initiating dialysis.

"Evaluation of patient dialysis knowledge is a rapid and easy method to identify patients who may be at higher risk of not using an arteriovenous access both at dialysis initiation and after starting dialysis, and therefore may be candidates for targeted educational interventions. Further evaluation of the impact of patient dialysis knowledge and the improvement in knowledge level in larger studies is needed to better understand its relationship with clinical measures and to provide guidance for improved chronic hemodialysis patient education," the authors conclude.

A program in which the subjects were enrolled was supported by Amgen, Inc.

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