Veterans more likely to start hemodialysis with an arteriovenous fistula.

Hemodialysis via arteriovenous fistulas (AVFs) is associated with reduced morbidity and mortality when compared to alternative vascular accesses, yet few patients in the United States start dialysis with AVFs. Recent studies have demonstrated higher quality of care for many conditions in Veterans Affairs' Medical Centers (VAMC); however, differences in quality of vascular access care are unknown. We used patient-level data (6/05-5/06) from Medicare claims (n = 25,912) to compare the proportions of AVF among incident patients at VAMC-affiliated (n = 20) and unaffiliated dialysis (n = 1631) facilities.

Perioperative outcomes among patients with end-stage renal disease following coronary artery bypass surgery in the USA.

Background: Patients with end-stage renal disease (ESRD) requiring chronic haemodialysis who undergo coronary artery bypass graft surgery (CABG) are at significant risk for perioperative mortality. However, the impact of changes in ESRD patient volume and characteristics over time on operative outcomes is unclear.

Methods: Using the Nationwide Inpatient Sample database (1988-03), we evaluated rates of CABG surgery with and without concurrent valve surgery among ESRD patients and outcomes including in-hospital mortality, and length of hospital stay.