Reinforced versus nonreinforced polytetrafluoroethylene grafts for hemodialysis access

Background Two major types of polytetrafluoroethylene (PTFE) graft material have been available for the past 20 years. Previous studies have suggested that nonreinforced PTFE performs better as a hemodialysis conduit than reinforced PTFE. We have had experience with both materials for the past 20 years. Methods This is an outcome study that is based on concurrent and retrospective data. Patients were accrued into the study from 1987 to 1995. There were 632 grafts that were entered onto a data base and analyzed by a biostatistician. Results Nonreinforced PTFE performed better than reinforced PTFE in every category and subgroup. Both mean duration and life-table analysis of the primary patency 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 all grafts was 1,554 days. Diabetic patients comprised 50% of the patient population. Conclusion Nonreinforced PTFE performs better than reinforced PTFE as a hemodialysis conduit. Until a multicentered prospective randomized study can be achieved, a preponderance of data suggests that nonreinforced PTFE should be the material of choice for hemodialysis access.