Abstract：
BACKGROUND: Although it is evident that a prior history of tunneled dialysis catheter (TDC) affects arteriovenous fistula (AVF) function, it is unclear whether its location (contralateral versus ipsilateral to AVF) has any effect on AVF maturation and failure rates. We aimed to document this possible effect.
METHODS: This systematic review and meta-analysis were performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies comparing outcomes between patients with contralateral TDC (CONTRA group) and those with ipsilateral one (IPSI group) were examined for inclusion. A random effects model meta-analysis of the odds ratio (OR) was conducted. Primary outcomes were AVF functional maturation, assisted maturation, and failure rates.
RESULTS: Four eligible studies comprising 763 patients were included in the meta-analysis. There were no significant differences in terms of AVF functional maturation (OR: 1.49; 95% confidence interval [CI]: 0.64-3.47; I2 = 83.4%), assisted maturation (OR: 0.59; 95% CI: 0.29-1.19; I2 = 61.4%), and failure rates (OR: 0.67; 95% CI: 0.29-1.58; I2 = 83.3%) between the 2 study groups.
CONCLUSIONS: TDC laterality seems not to affect fistula maturation rate in patients requiring TDC placement and concurrent AVF creation, but rather, vein- and patient-related characteristics might play a more important role in choosing TDC access site. Further studies are needed to validate these results.
METHODS: This systematic review and meta-analysis were performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies comparing outcomes between patients with contralateral TDC (CONTRA group) and those with ipsilateral one (IPSI group) were examined for inclusion. A random effects model meta-analysis of the odds ratio (OR) was conducted. Primary outcomes were AVF functional maturation, assisted maturation, and failure rates.
RESULTS: Four eligible studies comprising 763 patients were included in the meta-analysis. There were no significant differences in terms of AVF functional maturation (OR: 1.49; 95% confidence interval [CI]: 0.64-3.47; I2 = 83.4%), assisted maturation (OR: 0.59; 95% CI: 0.29-1.19; I2 = 61.4%), and failure rates (OR: 0.67; 95% CI: 0.29-1.58; I2 = 83.3%) between the 2 study groups.
CONCLUSIONS: TDC laterality seems not to affect fistula maturation rate in patients requiring TDC placement and concurrent AVF creation, but rather, vein- and patient-related characteristics might play a more important role in choosing TDC access site. Further studies are needed to validate these results.
摘要：
目的：尽管很明显，隧道透析导管（TDC）的既往病史会影响动静脉瘘（AVF）功能，尚不清楚其位置(AVF的对侧和同侧)是否对AVF成熟和失败率有任何影响.我们旨在记录这种可能的影响。
方法：本系统综述和荟萃分析按照PRISMA指南进行。研究比较对侧TDC患者（CONTRA组）和同侧TDC患者（IPSI组）的结局。对比值比(OR)进行随机效应模型荟萃分析。主要结果是AVF功能成熟，辅助成熟,和故障率。
结果：4项纳入763例患者的合格研究纳入荟萃分析。在AVF功能成熟方面没有显着差异（OR：1.49;95％CI：0.64-3.47;I2=83.4％），辅助成熟（OR：0.59；95%CI：0.29-1.19；I2=61.4%），2个研究组的失败率(OR:0.67;95%CI:0.29-1.58;I2=83.3%)。
结论：TDC侧向性似乎不影响需要TDC放置和并发AVF产生的患者的瘘管成熟率。而是,静脉和患者相关特征可能在选择TDC进入部位中起更重要的作用。需要进一步的研究来验证这些结果。
方法：本系统综述和荟萃分析按照PRISMA指南进行。研究比较对侧TDC患者（CONTRA组）和同侧TDC患者（IPSI组）的结局。对比值比(OR)进行随机效应模型荟萃分析。主要结果是AVF功能成熟，辅助成熟,和故障率。
结果：4项纳入763例患者的合格研究纳入荟萃分析。在AVF功能成熟方面没有显着差异（OR：1.49;95％CI：0.64-3.47;I2=83.4％），辅助成熟（OR：0.59；95%CI：0.29-1.19；I2=61.4%），2个研究组的失败率(OR:0.67;95%CI:0.29-1.58;I2=83.3%)。
结论：TDC侧向性似乎不影响需要TDC放置和并发AVF产生的患者的瘘管成熟率。而是,静脉和患者相关特征可能在选择TDC进入部位中起更重要的作用。需要进一步的研究来验证这些结果。
