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. 2018 Jul 6;13(7):1063-1068.
doi: 10.2215/CJN.14001217. Epub 2018 May 8.

Prevalence of Central Vein Stenosis in Patients Referred for Vein Mapping

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Free PMC article

Prevalence of Central Vein Stenosis in Patients Referred for Vein Mapping

Fasika M Tedla et al. Clin J Am Soc Nephrol. .
Free PMC article

Abstract

Background and objectives: Central vein stenosis is considered to be common in patients on hemodialysis but its exact prevalence is not known. In this study, we report the prevalence of central vein stenosis in patients with CKD referred for vein mapping.

Design, setting, participants, & measurements: We conducted a retrospective study of adult patients who had bilateral upper extremity venographic vein mapping from September 1, 2011 to December 31, 2015. Patients with and without stenosis were compared for differences in clinical or demographic characteristics. Multiple logistic regression was used to identify independent associations between patient characteristics and central vein stenosis.

Results: There were 525 patients who underwent venographic vein mapping during the study period, 27% of whom were referred before initiation of hemodialysis. The mean age (±SD) and body mass index were 59 (±15) years and 28 (±7), respectively. Women accounted for 45% of patients; 82% were black. The prevalence of central vein stenosis was 10% (95% confidence interval [95% CI], 8% to 13%) for the whole group, and 13% (95% CI, 10% to 17%) among patients with tunneled central venous dialysis catheters. Current use of tunneled hemodialysis catheters (odds ratio [OR], 14.5; 95% CI, 3.25 to 65.1), presence of cardiac rhythm devices (OR, 5.07; 95% CI, 1.82 to 14.11), previous history of fistula or graft (OR, 3.28; 95% CI, 1.58 to 6.7), and history of previous kidney transplant (OR, 18; 95% CI, 4.7 to 68.8) were independently associated with central vein stenosis.

Conclusions: In this population, the prevalence of central vein stenosis was 10% and was clustered among those with tunneled hemodialysis catheters, cardiac rhythm device, and previous history of dialysis access or transplant.

Keywords: Adult; Body Mass Index; Central Vein Stenosis; Central Venous Catheters; Confidence Intervals; Constriction, Pathologic; ESKD; ESRD; Female; Fistula; Humans; Logistic Models; Odds Ratio; Phlebography; Prevalence; Renal Insufficiency, Chronic; Retrospective Studies; Vein Mapping; Veins; chronic kidney disease; dialysis; kidney transplantation; renal dialysis.

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Figure 1.
Figure 1.
Flow diagram of patients included in the study: 53 of 525 patients in the study had central vein stenosis.

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