Impact of prepared vascular access on mortality and medical expenses in elderly and non-elderly Japanese patients with chronic kidney disease stage G5: a retrospective cohort study. Clin Exp Nephrol 2025 Aug;29(8):1063-1074
Date
03/18/2025Pubmed ID
40100518Pubmed Central ID
PMC12331761DOI
10.1007/s10157-025-02654-3Scopus ID
2-s2.0-105000385177 (requires institutional sign-in at Scopus site)Abstract
BACKGROUND: Patients with chronic kidney disease (CKD) stage 5 (CKDG5) have greater dialysis requirements that increase the risk of cardiovascular disease and mortality. The elevated costs associated with CKDG5 are a serious concern. The impact of prepared vascular access (VA) through planned VA creation on mortality and medical expenses remains unclear in Japanese patients with CKDG5.
METHODS: We conducted a retrospective cohort study including 157 patients with CKD who started hemodialysis (HD) at Shinshu University Hospital from April 2016 to March 2021 and assessed the relationship between the presence of a prepared VA and mortality and hospitalization expenses in elderly and non-elderly patients with CKDG5.
RESULTS: The presence of a prepared VA was associated with lower mortality in non-elderly patients but not in elderly patients. Medical expenses, emergency HD, and hospitalization duration were significantly lower in patients with a prepared VA in both age groups. The contribution of a prepared VA to mortality and medical expenses remained consistent after adjusting for sex, performance status, comorbidities, and nutritional status.
CONCLUSION: A prepared VA showed several benefits, including lower mortality rates and hospitalization costs; shorter hospital stays; and higher home discharge rates. Planned VA creation was significantly associated with lower hospitalization expenses, irrespective of age.
Author List
Nimura T, Harada M, Aomura D, Yamaka K, Hashimoto K, Kamijo YAuthor
Kosuke Yamaka Postdoctoral Researcher in the Physiology department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
Age FactorsAged
Aged, 80 and over
Arteriovenous Shunt, Surgical
Female
Hospital Costs
Hospitalization
Humans
Japan
Length of Stay
Male
Middle Aged
Renal Dialysis
Renal Insufficiency, Chronic
Retrospective Studies
