Article: Feasibility and outcomes of native arteriovenous fistula in octogenarians.
2020 Volume 95, Issue 3, Page(s) 136–142
Abstract: Introduction: While the native arteriovenous fistula (AVF) is the preferred dialysis access, it is a matter of debate for individuals older than 80 years due to reduced primary patency rates.: Materials and methods: We initiated a single-center, ... ...
| Abstract | Introduction: While the native arteriovenous fistula (AVF) is the preferred dialysis access, it is a matter of debate for individuals older than 80 years due to reduced primary patency rates. Materials and methods: We initiated a single-center, observational retrospective analysis of adult dialysis patients from January 2015 to December 2018. We included all patients older than 70 years with a minimum of 12 months of follow-up, beginning from the AVF creation. Patients were separated into two groups, octogenarians (> 80 years old) and controls (70 - 79 years old). The primary end point was the primary patency (the interval from arteriovenous access creation to the first intervention). The secondary end point were the complications at 3 months (failures of puncture, canceled dialysis sessions, local hematoma, AVF bleeding). Results: 29 patients (octogenarian = 17, control = 12) were included in the analysis. The AVF radio-cephalic was the most common vascular access in each group. Primary patency was comparable between groups, but octogenarians required 40% more procedures to obtain or maintain patency. Overall, a functional AVF was obtained for all patients except in cases of complications such as hematomas, which were more frequent in octogenarians compared to controls (25 vs. 82%, p < 0.01). All catheters were removed at 6 months follow-up, with a median time to removal of 27 days (range 5 - 157 days). Discussion: Despite a higher rate of interventions and local complications during the first 3 months, AVF and particularly radio-cephalic AVF, is a valid procedure for octogenarians, without lengthening the exposure time to the catheter. |
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| MeSH term(s) | Aged ; Aged, 80 and over ; Arteriovenous Shunt, Surgical/adverse effects ; Arteriovenous Shunt, Surgical/methods ; Feasibility Studies ; Humans ; Renal Dialysis/adverse effects ; Renal Dialysis/methods ; Retrospective Studies ; Treatment Outcome ; Vascular Access Devices/adverse effects ; Vascular Patency |
| Language | English |
| Publishing date | 2020-11-19 |
| Publishing country | Germany |
| Document type | Journal Article ; Observational Study |
| ZDB-ID | 185101-9 |
| ISSN | 0301-0430 |
| ISSN | 0301-0430 |
| DOI | 10.5414/CN110128 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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