An age-based comparison of fistula location, patency, and maturation for elderly renal failure patients
An age-based comparison of fistula location, patency, and maturation for elderly renal failure patients
复制标题
老年肾功能衰竭患者瘘管位置、通畅率和成熟度的年龄比较
DOI：
10.1016/j.jvs.2017.08.080
复制
发表时间：
2018-05-01
影响因子：
4.3
通讯作者：
Hsiang, York
中科院分区：
文献类型：
--
作者：
Misskey, Jonathan;Faulds, Jason;Hsiang, York
Objective: Current Kidney Disease Outcomes Quality Initiative guidelines do not incorporate age in determining autogenous arteriovenous hemodialysis access placement, and the optimal initial configuration in elderly patients remains controversial. We compared patency, maturation, survival, and complications between several age cohorts (80 years) to determine whether protocols should be modified to account for advanced age.Methods: All patients at two teaching hospitals undergoing a first autogenous arteriovenous access creation in either arm between 2007 and 2013 were retrospectively analyzed from a prospectively maintained database. Kaplan-Meier survival and Cox hazards models were used to compare access patency and risk factors for failure.Results: There were 941 autogenous arteriovenous accesses (median follow-up, 23 months; range, 0-89 months) eligible for inclusion; 152 (15.3%) accesses were created in those >80 years, 397 (42.2%) in those 65 to 79 years, and 392 (41.8%) in those 80 years, 65 to 79 years, and 80 years, 65 to 79 years, and 80 years demonstrated superior brachiocephalic vs radiocephalic secondary patencies (P = .048 and P = .015, respectively); however, no differences between configuration and secondary patency were observed within the cohort 65 years were associated with secondary patency loss.Conclusions: Patients aged 65 to 79 years and >80 years had inferior primary, primary assisted, and secondary patency and maturation compared with those 80 years and were an independent predictor of secondary patency loss.
