Ahrabi Amirali, Poshtdar Sepideh, Salimi Javad, Ashouri Mohammad, Yaseri Mehdi
Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran.
School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
BMC Nephrol. 2025 Aug 13;26(1):457. doi: 10.1186/s12882-025-04393-9.
To assess satisfaction and perspectives of adult hemodialysis (HD) patients on different vascular access (VA) types (AVF, AVG, CVC) by synthesizing quantitative studies using validated questionnaires, focusing on overall satisfaction, physical symptoms, social functioning, and complications.
We systematically searched Medline, Web of Science, and Scopus for studies assessing adult HD patients' perspectives on VA using structured questionnaires. Risk of bias was assessed using the Newcastle-Ottawa Scale. Meta-analysis was performed using a random-effects model across three pairwise comparisons: AVF vs. CVC, AVF vs. AVG, and CVC vs. AVG.
Of 1,253 records, 11 studies (n = 2910) met inclusion criteria. AVF patients had higher overall satisfaction compared to those with CVCs (MD: 7.06%, 95% CI: 2.98-11.14). Compared to AVG, AVF patients had higher overall satisfaction, though not statistically significant (MD: 5.12%, 95% CI: - 0.42 to 10.66; p = 0.069). Dissatisfaction with physical symptoms was significantly higher in AVF patients than in those with CVCs (MD: 8.76%, 95% CI: 4.19 to 13.34). Compared to CVC, AVF patients reported significantly lower dissatisfaction in both social functioning (MD: - 9.48%, 95% CI: - 15.98 to - 2.98) and dialysis-related complications (MD: - 10.08%, 95% CI: -12.66 to -7.50).
AVFs are associated with higher overall patient satisfaction compared to other VA types. While AVF patients experience more physical discomfort, this is outweighed by significantly greater satisfaction in areas such as social functioning and dialysis-related complications. These findings emphasize the importance of considering patient-reported outcomes when evaluating VA options in HD care.
Not applicable.
通过使用经过验证的问卷综合定量研究，评估成年血液透析（HD）患者对不同血管通路（VA）类型（自体动静脉内瘘[AVF]、人工血管动静脉内瘘[AVG]、中心静脉导管[CVC]）的满意度和看法，重点关注总体满意度、身体症状、社会功能和并发症。
我们系统检索了Medline、科学引文索引和Scopus数据库，以查找使用结构化问卷评估成年HD患者对VA看法的研究。使用纽卡斯尔-渥太华量表评估偏倚风险。采用随机效应模型对三组两两比较进行荟萃分析：AVF与CVC、AVF与AVG、CVC与AVG。
在1253条记录中，11项研究（n = 2910）符合纳入标准。与使用CVC的患者相比，AVF患者的总体满意度更高（平均差：7.06%，95%置信区间：2.98 - 11.14）。与AVG相比，AVF患者的总体满意度更高，尽管无统计学意义（平均差：5.12%，95%置信区间：-0.42至10.66；p = 0.069）。AVF患者对身体症状的不满显著高于使用CVC的患者（平均差：8.76%，95%置信区间：4.19至13.34）。与CVC相比，AVF患者在社会功能（平均差：-9.48%，95%置信区间：-15.98至-2.98）和透析相关并发症（平均差：-10.08%，95%置信区间：-12.66至-7.50）方面的不满均显著更低。
与其他VA类型相比，AVF与患者更高的总体满意度相关。虽然AVF患者经历更多身体不适，但在社会功能和透析相关并发症等方面显著更高的满意度弥补了这一点。这些发现强调了在HD护理中评估VA选项时考虑患者报告结局的重要性。
不适用。
