In a special webinar being presented today, researchers from the Dialysis Outcomes and Practice Patterns Study (DOPPS) will examine data from its Practice Monitor (DPM) on the state of access placement in the United States.

The Monitor is a sampling of over 200 dialysis clinics and 14,000 patients that generates reports with more than 1,500 regularly updated charts, figures, and data tables. The latest data will cover emerging trends in US hemodialysis (HD) practice through December 2014, with a focus on vascular access practices and international comparisons.

The DPM now includes over four years of trends in U.S. dialysis care, including comparisons by race, rural and geographic location, affiliated dialysis organization size, facility profit status, and hospital-based setting.

Key messages about access

Researchers will explain the practice patterns they see from data gathered by the monitor, including:

Though fistula use in the U.S. has risen among prevalent dialysis patients, the majority of patients still start dialysis with a catheter –– even those who see a nephrologist prior to starting  therapy.

Vascular access use varies widely across DOPPS countries. In Japan and Russia, 91-92% of hemodialysis patients use a fistula, but only 49% of Canadian patients do (in the U.S., it is at 68%) in prevalent cross-sections of hemodialysis patients.

Arteriovenous graft use was twice as high in black patients (26%) than others in the U.S.

Read also: Racial disparities seen in fistula use for dialysis patients

Despite large improvements in arteriovenous fistula use in prevalent hemodialysis patients during the last 15 years, arteriovenous fistula use has remained low among new patients when initiating HD and has shown essentially no improvement in 15 years. 

CVC use at hemodialysis initiation has remained high (at 70% among patients at DOPPS study entry and within 60 days of hemodialysis initiation)

U.S. hemodialysis facilities report "typical" times to first arteriovenous fistula cannulation that are generally longer than most other countries in DOPPS

Learn more about access and other clincial measures during the webinar hosted by DOPPS researchers, being held today at 3:00 EST. Register here.

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