Goal This project is designed to contribute institutional data to a multi-institutional registry to evaluate the impact of socioeconomic disparities on the long-term outcomes of hemodialysis access, including the choice of access modality that the patient recieve, the long term patency of hemodialysis access and their access to healthcare services overall. Specific Objectives To determine the most prevalent type of access that patients from disadvantageous socioeconomic background receive. Hypothesis: Patients from the H-ADI group are likely to have lower overall long term survival in comparison to patients from the L-ADI group. Primary Endpoint: Patient survival over time. Hypothesis: Patients from the H-ADI group are likely to have higher prevalence of hemodialysis catheter placement as well as longer total duration of the catheter in comparison to patients from the L-ADI group. Primary Endpoint: Prevalence of hemodialysis catheter placement in both groups as well as total duration (in days) of catheter dependence in both groups prior to successful use of AVF/AVG. To determine long term survival of hemodialysis access patients in both groups Hypothesis: Patients in the H-ADI group will likely have lower fistula maturation rates as well as functional patency rates at 1 and 3 years in comparison to the patients in the L-ADI group. Primary Endpoint: Fistula maturation rate Secondary Endpoints: Number of procedures to attain maturity; functional patency at 1 and 3 years To determine the prevalence of hemodialysis catheter, use in both groups and compare total duration of catheter placement. Hypothesis: Patients from the highest quantile ADI score (those at the highest level of socioeconomic deprivation) are more likely to receive AVG as opposed to AVF. Primary Endpoint: Type of hemodialysis access in the highest quintile (H-ADI) vs the lowest four quintiles (L-ADI) To examine the outcomes and overall patency of hemodialysis access in patients of the highest quintile (H-ADI) vs the lowest four quintiles (L-ADI)
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