Autologous arteriovenous fistula is associated with superior outcomes in elderly hemodialysis patients
Autologous arteriovenous fistula is associated with superior outcomes in elderly hemodialysis patients
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DOI：
10.1186/s12882-018-1109-9
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发表时间：
2018-11-06
期刊：
影响因子：
2.3
通讯作者：
Joo, Kwon Wook
中科院分区：
文献类型：
--
作者：
Bae, Eunjin;Lee, Hajeong;Joo, Kwon Wook
研究背景老年终末期肾病患者的数量正在迅速增加。这些患者的合并症患病率较高，预期寿命较短，因此难以决定血管通路（VA）的类型。我们探讨了最佳的选择VA在老年血液透析patients.MethodsWe包括老年患者（> 65岁）访问我们的VA诊所，并将他们分为三组，如下：桡头动静脉瘘（AVF），头臂AVF，和人工动静脉移植（AVG）。主要结局为VA放弃和全因死亡率。次要结局是成熟失败（MF）。结果529例患者中，61.2%为男性。平均年龄73.66.0岁。VA类型为桡头型AVF占49.9%，头臂型AVF占31.8%，AVG占18.3%。AVG患者倾向于年龄较大、女性和体重指数较低。超过一半的患者（n=302，57.1%）使用中心导管开始透析，但透析前中心导管放置的比例在VA类型之间没有差异。放射头AVF在VA放弃率（P=0.005）和全因死亡率（P
BackgroundThe number of elderly patients with end-stage renal disease is increasing rapidly. The higher prevalence of comorbidities and shorter life expectancy in these patients make it difficult to decide on the type of vascular access (VA). We explored the optimal choice for VA in elderly hemodialysis patients.MethodsWe included elderly patients (>65years) visiting our VA clinic and divided them into three groups as follows: radiocephalic arteriovenous fistula (AVF), brachiocephalic AVF, and prosthetic arteriovenous graft (AVG). The primary outcomes were VA abandonment and all-cause mortality. The secondary outcome was maturation failure (MF).ResultsOf 529 patients, 61.2% were men. The mean age was 73.66.0years. The VA types were as follows: 49.9% radiocephalic AVF, 31.8% brachiocephalic AVF, and 18.3% AVG. Patients with an AVG tended to be older, female, and have a lower body mass index. More than half of patients (n=302, 57.1%) started dialysis with central catheters, but the proportion of predialysis central catheter placement was not different among the VA types. Radiocephalic AVF was significantly superior to AVG in terms of VA abandonment (P=0.005) and all-cause mortality (P