Publication Spotlight: Dr. Lyu

Read the below interview with Beini Lyu, PhD, Research Associate, Johns Hopkins Bloomberg School of Public Health and author of Arteriovenous Access Type and Risk of Mortality, Hospitalization, and Sepsis Among Elderly Hemodialysis Patients: A Target Trial Emulation Approach.

What question did your study aim to answer?

We aimed to compare the effect of arteriovenous fistula (AVF) vs. arteriovenous graft (AVG) creation on several critical outcomes among elderly patients on hemodialysis.

What inspired you to conduct this study?

It is not clear whether AVF or AVG is more appropriate for elderly patients on hemodialysis. Results from previous observational studies are inconsistent and may suffer from bias. Ideally, this question would be answered by RCT, but we don’t have such data, yet. We aimed to emulate a RCT using data from USRDS to answer this question.

Which USRDS datasets did you use to conduct your study?

We used the Core, Hospital, CROWNWEb Clinical Data, Institutional Claims, Physician/Supplier Claims, pre-ESRD Institutional Claims, and pre-ESRD Physician/Supplier Claims data.

Using plain language, please summarize your study conclusions in two or three points.

We found no differences between AVGs and AVFs with respect to mortality, sepsis, or all-cause, cardiovascular-related, and infection-related hospitalization after accounting for potential bias and confounding factors. Our work supports equipoise between creation of AVFs versus AVGs among elderly patients who initiate hemodialysis with a catheter.

Please share a specific insight about working with USRDS data that you learned during the completion of this study.

USRDS data are very well-organized and documented. The USRDS Researcher's Guide and appendix and analytic methods were extremely helpful when I started exploring USRDS data.