A comparison of arteriovenous fistula failure between Malaysian and Australian and New Zealand participants enrolled in the FAVOURED trial

Rebecca Hudson; Elaine M. Pascoe; Yong Pey See; Yeoungjee Cho; Kevan R. Polkinghorne; Peta Anne Paul-Brent; Lai Seong Hooi; Loke Meng Ong; Trevor A. Mori; Sunil V. Badve; Alan Cass; Peter G. Kerr; David Voss; Carmel M. Hawley; David W. Johnson; Ashley B. Irish; Andrea K. Viecelli

doi:10.1177/11297298221099134

A comparison of arteriovenous fistula failure between Malaysian and Australian and New Zealand participants enrolled in the FAVOURED trial

Rebecca Hudson, Elaine M. Pascoe, Yong Pey See, Yeoungjee Cho, Kevan R. Polkinghorne, Peta Anne Paul-Brent, Lai Seong Hooi, Loke Meng Ong, Trevor A. Mori, Sunil V. Badve, Alan Cass, Peter G. Kerr, David Voss, Carmel M. Hawley, David W. Johnson, Ashley B. Irish, Andrea K. Viecelli

Menzies School of Health Research

Research output: Contribution to journal › Article › peer-review

Abstract

Aim: To describe and compare de novo arteriovenous fistula (AVF) failure rates between Australia and New Zealand (ANZ), and Malaysia.

Background: AVFs are preferred for haemodialysis access but are limited by high rates of early failure.

Methods: A post hoc analysis of 353 participants from ANZ and Malaysia included in the FAVOURED randomised-controlled trial undergoing de novo AVF surgery was performed. Composite AVF failure (thrombosis, abandonment, cannulation failure) and its individual components were compared between ANZ (n = 209) and Malaysian (n = 144) participants using logistic regression adjusted for patient- and potentially modifiable clinical factors.

Results: Participants’ mean age was 55 ± 14.3 years and 64% were male. Compared with ANZ participants, Malaysian participants were younger with lower body mass index, higher prevalence of diabetes mellitus and lower prevalence of cardiovascular disease. AVF failure was less frequent in the Malaysian cohort (38% vs 54%; adjusted odds ratio (OR) 0.53, 95% confidence interval (CI) 0.31–0.93). This difference was driven by lower odds of cannulation failure (29% vs 47%, OR 0.45, 95% CI 0.25–0.80), while the odds of AVF thrombosis (17% vs 20%, OR 1.24, 95% CI 0.62–2.48) and abandonment (25% vs 23%, OR 1.17, 95% CI 0.62–2.16) were similar.

Conclusions: The risk of AVF failure was significantly lower in Malaysia compared to ANZ and driven by a lower risk of cannulation failure. Differences in practice patterns, including patient selection, surgical techniques, anaesthesia or cannulation techniques may account for regional outcome differences and warrant further investigation.

Original language	English
Pages (from-to)	193 - 202
Number of pages	10
Journal	Journal of Vascular Access
Volume	25
Issue number	1
Early online date	2022
DOIs	https://doi.org/10.1177/11297298221099134
Publication status	Published - Jan 2024

Bibliographical note

Funding Information:
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: The FAVOURED trial was funded by grants from the NHMRC of Australia Project Grant (Grant number APP458652), Amgen Australia Pty Ltd and Mylan EPD (at the time of funding was Abbott Products Operations AG). Study medication was supplied by Mylan EPD (at the time of supply was Abbott Products Operations AG) (fish oil and placebo) and Bayer Healthcare
(aspirin and placebo) free of charge.

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Hudson, R., Pascoe, E. M., See, Y. P., Cho, Y., Polkinghorne, K. R., Paul-Brent, P. A., Hooi, L. S., Ong, L. M., Mori, T. A., Badve, S. V., Cass, A., Kerr, P. G., Voss, D., Hawley, C. M., Johnson, D. W., Irish, A. B., & Viecelli, A. K. (2024). A comparison of arteriovenous fistula failure between Malaysian and Australian and New Zealand participants enrolled in the FAVOURED trial. Journal of Vascular Access, 25(1), 193 - 202. https://doi.org/10.1177/11297298221099134

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title = "A comparison of arteriovenous fistula failure between Malaysian and Australian and New Zealand participants enrolled in the FAVOURED trial",

abstract = "Aim: To describe and compare de novo arteriovenous fistula (AVF) failure rates between Australia and New Zealand (ANZ), and Malaysia. Background: AVFs are preferred for haemodialysis access but are limited by high rates of early failure. Methods: A post hoc analysis of 353 participants from ANZ and Malaysia included in the FAVOURED randomised-controlled trial undergoing de novo AVF surgery was performed. Composite AVF failure (thrombosis, abandonment, cannulation failure) and its individual components were compared between ANZ (n = 209) and Malaysian (n = 144) participants using logistic regression adjusted for patient- and potentially modifiable clinical factors. Results: Participants{\textquoteright} mean age was 55 ± 14.3 years and 64% were male. Compared with ANZ participants, Malaysian participants were younger with lower body mass index, higher prevalence of diabetes mellitus and lower prevalence of cardiovascular disease. AVF failure was less frequent in the Malaysian cohort (38% vs 54%; adjusted odds ratio (OR) 0.53, 95% confidence interval (CI) 0.31–0.93). This difference was driven by lower odds of cannulation failure (29% vs 47%, OR 0.45, 95% CI 0.25–0.80), while the odds of AVF thrombosis (17% vs 20%, OR 1.24, 95% CI 0.62–2.48) and abandonment (25% vs 23%, OR 1.17, 95% CI 0.62–2.16) were similar. Conclusions: The risk of AVF failure was significantly lower in Malaysia compared to ANZ and driven by a lower risk of cannulation failure. Differences in practice patterns, including patient selection, surgical techniques, anaesthesia or cannulation techniques may account for regional outcome differences and warrant further investigation.",

keywords = "Arteriovenous fistula, aspirin, cannulation failure, fish oils, haemodialysis, kidney failure, vascular access outcome",

author = "Rebecca Hudson and Pascoe, {Elaine M.} and See, {Yong Pey} and Yeoungjee Cho and Polkinghorne, {Kevan R.} and Paul-Brent, {Peta Anne} and Hooi, {Lai Seong} and Ong, {Loke Meng} and Mori, {Trevor A.} and Badve, {Sunil V.} and Alan Cass and Kerr, {Peter G.} and David Voss and Hawley, {Carmel M.} and Johnson, {David W.} and Irish, {Ashley B.} and Viecelli, {Andrea K.}",

note = "Funding Information: The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: The FAVOURED trial was funded by grants from the NHMRC of Australia Project Grant (Grant number APP458652), Amgen Australia Pty Ltd and Mylan EPD (at the time of funding was Abbott Products Operations AG). Study medication was supplied by Mylan EPD (at the time of supply was Abbott Products Operations AG) (fish oil and placebo) and Bayer Healthcare (aspirin and placebo) free of charge.",

year = "2024",

month = jan,

doi = "10.1177/11297298221099134",

language = "English",

volume = "25",

pages = "193 -- 202",

journal = "Journal of Vascular Access",

issn = "1129-7298",

publisher = "Wichtig Publishing",

number = "1",

}

Hudson, R, Pascoe, EM, See, YP, Cho, Y, Polkinghorne, KR, Paul-Brent, PA, Hooi, LS, Ong, LM, Mori, TA, Badve, SV, Cass, A, Kerr, PG, Voss, D, Hawley, CM, Johnson, DW, Irish, AB & Viecelli, AK 2024, 'A comparison of arteriovenous fistula failure between Malaysian and Australian and New Zealand participants enrolled in the FAVOURED trial', Journal of Vascular Access, vol. 25, no. 1, pp. 193 - 202. https://doi.org/10.1177/11297298221099134

TY - JOUR

T1 - A comparison of arteriovenous fistula failure between Malaysian and Australian and New Zealand participants enrolled in the FAVOURED trial

AU - Hudson, Rebecca

AU - Pascoe, Elaine M.

AU - See, Yong Pey

AU - Cho, Yeoungjee

AU - Polkinghorne, Kevan R.

AU - Paul-Brent, Peta Anne

AU - Hooi, Lai Seong

AU - Ong, Loke Meng

AU - Mori, Trevor A.

AU - Badve, Sunil V.

AU - Cass, Alan

AU - Kerr, Peter G.

AU - Voss, David

AU - Hawley, Carmel M.

AU - Johnson, David W.

AU - Irish, Ashley B.

AU - Viecelli, Andrea K.

N1 - Funding Information: The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: The FAVOURED trial was funded by grants from the NHMRC of Australia Project Grant (Grant number APP458652), Amgen Australia Pty Ltd and Mylan EPD (at the time of funding was Abbott Products Operations AG). Study medication was supplied by Mylan EPD (at the time of supply was Abbott Products Operations AG) (fish oil and placebo) and Bayer Healthcare (aspirin and placebo) free of charge.

PY - 2024/1

Y1 - 2024/1

N2 - Aim: To describe and compare de novo arteriovenous fistula (AVF) failure rates between Australia and New Zealand (ANZ), and Malaysia. Background: AVFs are preferred for haemodialysis access but are limited by high rates of early failure. Methods: A post hoc analysis of 353 participants from ANZ and Malaysia included in the FAVOURED randomised-controlled trial undergoing de novo AVF surgery was performed. Composite AVF failure (thrombosis, abandonment, cannulation failure) and its individual components were compared between ANZ (n = 209) and Malaysian (n = 144) participants using logistic regression adjusted for patient- and potentially modifiable clinical factors. Results: Participants’ mean age was 55 ± 14.3 years and 64% were male. Compared with ANZ participants, Malaysian participants were younger with lower body mass index, higher prevalence of diabetes mellitus and lower prevalence of cardiovascular disease. AVF failure was less frequent in the Malaysian cohort (38% vs 54%; adjusted odds ratio (OR) 0.53, 95% confidence interval (CI) 0.31–0.93). This difference was driven by lower odds of cannulation failure (29% vs 47%, OR 0.45, 95% CI 0.25–0.80), while the odds of AVF thrombosis (17% vs 20%, OR 1.24, 95% CI 0.62–2.48) and abandonment (25% vs 23%, OR 1.17, 95% CI 0.62–2.16) were similar. Conclusions: The risk of AVF failure was significantly lower in Malaysia compared to ANZ and driven by a lower risk of cannulation failure. Differences in practice patterns, including patient selection, surgical techniques, anaesthesia or cannulation techniques may account for regional outcome differences and warrant further investigation.

AB - Aim: To describe and compare de novo arteriovenous fistula (AVF) failure rates between Australia and New Zealand (ANZ), and Malaysia. Background: AVFs are preferred for haemodialysis access but are limited by high rates of early failure. Methods: A post hoc analysis of 353 participants from ANZ and Malaysia included in the FAVOURED randomised-controlled trial undergoing de novo AVF surgery was performed. Composite AVF failure (thrombosis, abandonment, cannulation failure) and its individual components were compared between ANZ (n = 209) and Malaysian (n = 144) participants using logistic regression adjusted for patient- and potentially modifiable clinical factors. Results: Participants’ mean age was 55 ± 14.3 years and 64% were male. Compared with ANZ participants, Malaysian participants were younger with lower body mass index, higher prevalence of diabetes mellitus and lower prevalence of cardiovascular disease. AVF failure was less frequent in the Malaysian cohort (38% vs 54%; adjusted odds ratio (OR) 0.53, 95% confidence interval (CI) 0.31–0.93). This difference was driven by lower odds of cannulation failure (29% vs 47%, OR 0.45, 95% CI 0.25–0.80), while the odds of AVF thrombosis (17% vs 20%, OR 1.24, 95% CI 0.62–2.48) and abandonment (25% vs 23%, OR 1.17, 95% CI 0.62–2.16) were similar. Conclusions: The risk of AVF failure was significantly lower in Malaysia compared to ANZ and driven by a lower risk of cannulation failure. Differences in practice patterns, including patient selection, surgical techniques, anaesthesia or cannulation techniques may account for regional outcome differences and warrant further investigation.

KW - Arteriovenous fistula

KW - aspirin

KW - cannulation failure

KW - fish oils

KW - haemodialysis

KW - kidney failure

KW - vascular access outcome

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U2 - 10.1177/11297298221099134

DO - 10.1177/11297298221099134

M3 - Article

C2 - 35686506

AN - SCOPUS:85131761903

SN - 1129-7298

VL - 25

SP - 193

EP - 202

JO - Journal of Vascular Access

JF - Journal of Vascular Access

IS - 1

ER -

A comparison of arteriovenous fistula failure between Malaysian and Australian and New Zealand participants enrolled in the FAVOURED trial

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