Hemodialysis Facilities, Vascular Access Surgeons, and Central Venous Catheter Use: A Retrospective Cohort Study

The goal of this study was to learn if patients in dialysis facilities that partnered with surgeons (measured using a marker of market concentration) who place and maintain permanent hemodialysis vascular access grafts and fistulas experienced lower use of a temporary form of vascular access for hemodialysis, central venous catheters, which are associated with an increased risk of infection. We found that closer partnerships between hemodialysis centers and surgeons were associated with less use of catheters for the patients served by those dialysis centers. These findings may inform strategies to reduce the use of central venous catheters and improve outcomes for patients with kidney failure requiring dialysis.