REINFORCED VERSUS NONREINFORCED POLYTETRAFLUOROETHYLENE GRAFTS FOR HEMODIALYSIS ACCESS

BACKGROUND: Two major types of polytetrafluoroethylene (PTFE) graft ma terial have been available for the past 20 years, Previous studies hav e suggested that nonreinforced PTFE performs better as a hemodialysis conduit than reinforced PTFE. We have had experience with both materia ls for the past 20 years. METHODS: This is an outcome study that is ba sed on concurrent and retrospective data. Patients were accrued into t he study from 1987 to 1995. There were 632 grafts that were entered on to a data base and analyzed by a biostatistician. RESULTS: Nonreinforc ed PTFE performed better than reinforced PTFE in every category and su bgroup, Both mean duration and life-table analysis of the primary pate ncy were statistically significant (P < 0.05), The secondary patencies were similar, with 80% of the nonreinforced and 77% of the reinforced functioning at 1 year, The median duration for secondary patency of a ll grafts was 1,554 days, Diabetic patients comprised 50% of the patie nt population, CONCLUSION: Nonreinforced PTFE performs better than rei nforced PTFE as a hemodialysis conduit. Until a multicentered prospect ive randomized study can be achieved, a preponderance of data suggests that nonreinforced PTFE should be the material of choice for hemodial ysis access. (C) 1997 by Excerpta Medica, Inc.