Effects of age and diabetes on blood flow rate and primary outcome of newly created hemodialysis arteriovenous fistulas
Effects of age and diabetes on blood flow rate and primary outcome of newly created hemodialysis arteriovenous fistulas
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DOI：
10.1159/000013315
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发表时间：
1998-03-01
影响因子：
4.2
通讯作者：
Yen, TS
中科院分区：
文献类型：
--
作者：
Lin, SL;Huang, CH;Yen, TS
为了研究在老年和糖尿病患者中建立放射性头端血液透析内瘘的可行性，我们前瞻性研究了176例接受首次永久性血管通路建立的患者，并随访了内瘘的结局，直至评估原发性失败或成功。采用彩色双功超声检测血流速度。老年患者的瘘口血流速度明显较低，但78%以上的成功瘘口患者的瘘口血流速度>400 ml/min。非糖尿病患者和糖尿病患者的瘘口血流速度无差异。不同年龄组和不同糖尿病状态的患者通过瘘管进行透析的充分性（Kt/V）相同。老年或糖尿病本身并不显著增加新瘘管原发性失败的风险，但同时发生老年和糖尿病显著增加了风险。总之，老年和糖尿病患者新创建的桡头动脉瘘和通过瘘进行充分透析的主要结局良好。但是，老年人和糖尿病患者瘘管的寿命需要进一步研究。
To study the feasibility of creating a radiocephalic hemodialysis fistula in elderly and diabetic patients, we prospectively studied 176 patients undergoing the first permanent vascular access creation and followed the outcome of fistula until primary failure or success was assessed. Color duplex ultrasonography was used to measure the blood flow rate. Fistula blood flow rate was significantly smaller in elderly patients, however, it was >400 ml/min in over 78% of the elderly patients with successful fistulas. There was no difference in fistula blood flow rate between nondiabetics and diabetics. Dialysis adequacy (Kt/V) via fistula was the same between age groups and between diabetes mellitus status, Old age or diabetes per se did not significantly predispose a new fistula to primary failure, but concurrent old age and diabetes markedly increase the risk. In conclusion, a good primary outcome of newly created radiocephalic fistula and adequate dialysis via fistula were demonstrated for elderly and diabetic patients. However, the longevity of fistula in elderly and diabetic patients needs further study.