Survival and complications of arteriovenous fistula dialysis access in an elderly population
| Autor: | Adriana Baroni, Valerio Resentini, Loredana Funaro, Elvira Mancini, Maurizio Borzumati |
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| Rok vydání: | 2013 |
| Předmět: |
Male
congenital hereditary and neonatal diseases and abnormalities medicine.medical_specialty Time Factors medicine.medical_treatment Fistula Arteriovenous fistula Kaplan-Meier Estimate Risk Assessment Upper Extremity Arteriovenous Shunt Surgical Postoperative Complications Renal Dialysis Risk Factors medicine Humans cardiovascular diseases Renal replacement therapy Intensive care medicine Survival rate Dialysis Aged Retrospective Studies Aged 80 and over business.industry Incidence (epidemiology) Incidence Patient Selection Age Factors Graft Occlusion Vascular Retrospective cohort study Thrombosis medicine.disease Surgery Survival Rate Treatment Outcome Italy Nephrology Female business |
| Zdroj: | The journal of vascular access. 14(4) |
| ISSN: | 1724-6032 |
| Popis: | Purpose In recent years, the number of elderly uremic patients who commence renal replacement therapy has increased. A retrospective review assessed the survival rate and incidence of complications in elderly patients with an arteriovenous fistula (AVF) created between January 2000 and August 2008. Methods A total of 78 patients, 48 men and 30 women aged ≥75 with a mean age of 82.5±7.5, commenced hemodialysis therapy during the period under consideration; 31% were diabetic and all had a LVEF ≥30%. For this group of patients, 90 AVF were created: 41 distal AVF (45%), 32 proximal AVF (35%), 13 midarm AVF (15%), and four AV grafts (5%). Results The survival rate of the AVF was 76% at 12 months and 71% at 24 months. A total of 47 patients with functioning AVF (60%) died during the study period. There were 18 cases of thrombosis (20%). No significant local or systemic complications occurred. Conclusions Several aspects should be highlighted: pre-operative color-flow duplex scanning, timing of the creation of the AVF and placement of the AVF as distal as possible. The creation of AVF in elderly patients is a choice supported by the opinion that patients with tunneled central venous catheters have higher mortality rates than those with AVF. In summary, choosing vascular access sites to be created in elderly patients is no different than for younger patients–an AVF remains the gold standard. |
| Databáze: | OpenAIRE |
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