NEW research suggests that racial and ethnic differences exist in arteriovenous access (AVA) use in patients 1 year after haemodialysis initiation. The data, presented by Melandrea Worsley, Baylor College of Medicine, Houston, Texas, USA, and her team, showed that these differences persist despite recent improvements in AVA use at 1 year after initiation.
Data were collected from a large dialysis organisation, and 198,186 patients who had started haemodialysis with a central venous catheter (CVC) from 2006–2016, and remained on dialysis for at least 1 year, were identified. Of these patients, 67,315 (34%) were Black, 31,711 (16%) were Hispanic, 86,117 (43%) were White, and 13,043 (7%) were of other races or ethnicities. Use of AVA within 1 year of beginning haemodialysis with a CVC was plotted by calendar year.
The results showed that use of an AVA within 1 year increased in all racial and ethnic groups from 2006–2016. The team reported that Black patients had similar odds of using AVA within 1 year compared to White patients; however, those of other racial groups were consistently more likely to do so than White patients. Hispanic patients were often more likely than White patients to use an AVA. Findings additionally showed that Black patients were less likely to use an AVA placed in the preferred location in the lower arm when compared to patients in all other racial and ethnic groups.
Worsley and colleagues concluded that though there has been an improvement in AVA use 1 year after initiating haemodialysis with a CVC in all racial groups, the differences in AVA use and location remain. Less is known about these differences in vascular access creation, despite the importance of vascular access for patients on dialysis. “Further research is warranted to identify causative factors contributing to the racial and ethnic differences in AVA use, both at the time of haemodialysis initiation and 1 year after haemodialysis initiation with a CVC,” Worsley added.