Black patients more likely to experience dialysis graft failure, costly consequences

Black patients are more likely to experience failed dialysis grafts and the costly consequences that come with them, according to an analysis released Tuesday. Radiology [1].

Providers typically place these flexible tubes to create pathways between arteries and veins to facilitate dialysis. In particular, arteriovenous grafts are used in people with small or weak blood vessels. Graft failure can result in interventional radiologists having to perform maintenance procedures. Also, repeating the procedure within 30 days can lead to death, increasing costs and burdens for both patients and healthcare systems.

Experts recently sought to better understand how this phenomenon affects black patients in particular. , has been found to be a factor associated with early access failure. Analysis using Veterans Health Administration data shows a clear opportunity to address health inequities.

“African-American patients are more likely to experience early dialysis access dysfunction and failure than patients of other races,” said a senior director of radiology at Boston University’s Chovanian and Avedisian College of Medicine. said Mikhail CSS Higgins, M.D., assistant professor. statement. “This relative predisposition to this complication represents a disparity in care and adverse outcomes in a poorly studied population: the VHA system.”

This study utilized data representing all hemodialysis vascular maintenance procedures performed between October 2016 and March 2020. At 61 Veterans Health Care facilities, he identified a total of 1,950 her AV implant surgeries performed on 995 patients. Interventional radiologists handled the majority of such cases, most of which involved black patients (60%) and were delivered in the Southern US region (51%).

Grafts failed prematurely in approximately 11% of treatments, with race as a related factor (after adjusting for factors such as comorbidities). Half of the 61 sites surveyed had an interventional radiology resident training program, and these sites had low graft failure rates with no evidence of difference among the 1,057 surgeries. However, the authors caution that further research is needed to better understand this finding.

“Our results do not show this direct relationship, so we cannot say that patients should find hospitals with educational programs. It is likely that dialysis access maintenance procedures are associated with equitable patient outcomes, and that there are unmeasured factors related to educational programs that influence this relationship.”