Advanced age is not a barrier to creating a functional arteriovenous fistula: a retrospective study
| Autor: | Monica Beaulieu, Mercedeh Kiaii, Chance S. Dumaine, Alexandra Romann |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Adult
Male medicine.medical_specialty Time Factors medicine.medical_treatment 030232 urology & nephrology MEDLINE Vascular access Arteriovenous fistula 030204 cardiovascular system & hematology 03 medical and health sciences 0302 clinical medicine Arteriovenous Shunt Surgical Renal Dialysis Risk Factors medicine Vascular Patency Humans Treatment Failure Dialysis Aged Retrospective Studies Aged 80 and over British Columbia business.industry Age Factors Graft Occlusion Vascular Retrospective cohort study Middle Aged medicine.disease Surgery Nephrology Observational study Female Hemodialysis business |
| Zdroj: | The journal of vascular access. 18(4) |
| ISSN: | 1724-6032 |
| Popis: | Introduction Arteriovenous fistulas (AVFs) are the recommended form of vascular access for hemodialysis. However, controversy exists regarding whether AVFs are suitable for elderly patients. Methods Single-center retrospective review to investigate the impact of age on AVF outcomes. Five hundred and twenty-five patients with AVF creation were stratified based on age 75 years. AVF outcomes including primary failure, AVF patency (primary, secondary, and functional), and AVF complications were studied for 3 years following AVF creation. Results The cohort was 63% male, 44% Caucasian, and 55% had diabetes or cardiovascular disease. 39% were aged 75 years. No differences in rates of primary failure, loss of primary patency, complications, or need for intervention were observed between age groups. There was a significant association of age with secondary patency and functional patency, with age >75 being an independent risk factor for shortened lifespan of the fistula. For patients aged >75 years, secondary patency at 3 years was 64% compared to 75%-78% for younger patients. Functional patency at 2 years was 69% for those aged >75 years compared to 78%-81% for younger patients. Conclusions We found no difference in AVF maturation, primary patency, complications, or interventions in those over the age of 75 compared to younger counterparts. While secondary and functional patency rates were significantly lower in those aged >75 years, the magnitude of difference is likely not clinically relevant. Therefore, we recommend that advanced age alone should not preclude patients from AVF creation. |
| Databáze: | OpenAIRE |
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