Analysis of clinical outcomes of arteriovenous fistula for hemodialysis access in a Mexican elderly population

Abstract Objective. The increased survival rates of end-stage renal disease (ESRD) patients have impacted directly in the proportion of elderly patients requiring a reliable hemodialysis (HD) access; this group clearly demands an individualized approach. We aim to analyze maturation and patency rates of arteriovenous fistulas (AVF) in elderly patients. Methods. This was retrospective review of a database of patients that underwent AVF creation in our institution. The maturation and patency rates were analyzed divided in groups based on age (equal and greater of 65 years, and patients under 65 years). Patency rates were compared using Kaplan-Meier analysis. Results. Twenty patients ≥ 65 years old (mean 73, SD ± 5.4) were analyzed. The overall maturation rate in this group was 75% compared to 84.1% (p = 0.33) in the younger group (mean age 48 years, SD ± 17). The primary patency at 6 and 12 months for the ≥ 65 years group was 93% and 86%, respectively, compared with 85% and 81% for the younger group (p = 0.77). Conclusion. Autogenous AVF remains the preferred and durable option for elderly patients. We found no difference in terms of maturation and patency rates compared to younger patients. Standardized protocols are needed to optimally select vascular accesses.

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Main Authors: Contreras-Jimenez,Emmanuel, Lopez-Pena,Gabriel, Ruben-Castillo,Christopher, Teran-Ellis,Santiago Mier y, Cuen-Ojeda,Cesar, Arzola-Flores,Luis H., Anaya-Ayala,Javier E., Hinojosa,Carlos A.
Format: Digital revista
Language:English
Published: Academia Mexicana de Cirugía A.C. 2023
Online Access:http://www.scielo.org.mx/scielo.php?script=sci_arttext&pid=S2444-054X2023000200200
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spelling oai:scielo:S2444-054X20230002002002023-05-12Analysis of clinical outcomes of arteriovenous fistula for hemodialysis access in a Mexican elderly populationContreras-Jimenez,EmmanuelLopez-Pena,GabrielRuben-Castillo,ChristopherTeran-Ellis,Santiago Mier yCuen-Ojeda,CesarArzola-Flores,Luis H.Anaya-Ayala,Javier E.Hinojosa,Carlos A. Arteriovenous fistula Elderly End stage renal disease Abstract Objective. The increased survival rates of end-stage renal disease (ESRD) patients have impacted directly in the proportion of elderly patients requiring a reliable hemodialysis (HD) access; this group clearly demands an individualized approach. We aim to analyze maturation and patency rates of arteriovenous fistulas (AVF) in elderly patients. Methods. This was retrospective review of a database of patients that underwent AVF creation in our institution. The maturation and patency rates were analyzed divided in groups based on age (equal and greater of 65 years, and patients under 65 years). Patency rates were compared using Kaplan-Meier analysis. Results. Twenty patients ≥ 65 years old (mean 73, SD ± 5.4) were analyzed. The overall maturation rate in this group was 75% compared to 84.1% (p = 0.33) in the younger group (mean age 48 years, SD ± 17). The primary patency at 6 and 12 months for the ≥ 65 years group was 93% and 86%, respectively, compared with 85% and 81% for the younger group (p = 0.77). Conclusion. Autogenous AVF remains the preferred and durable option for elderly patients. We found no difference in terms of maturation and patency rates compared to younger patients. Standardized protocols are needed to optimally select vascular accesses.info:eu-repo/semantics/openAccessAcademia Mexicana de Cirugía A.C.Cirugía y cirujanos v.91 n.2 20232023-04-01info:eu-repo/semantics/articletext/htmlhttp://www.scielo.org.mx/scielo.php?script=sci_arttext&pid=S2444-054X2023000200200en10.24875/ciru.22000217
institution SCIELO
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country México
countrycode MX
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region America del Norte
libraryname SciELO
language English
format Digital
author Contreras-Jimenez,Emmanuel
Lopez-Pena,Gabriel
Ruben-Castillo,Christopher
Teran-Ellis,Santiago Mier y
Cuen-Ojeda,Cesar
Arzola-Flores,Luis H.
Anaya-Ayala,Javier E.
Hinojosa,Carlos A.
spellingShingle Contreras-Jimenez,Emmanuel
Lopez-Pena,Gabriel
Ruben-Castillo,Christopher
Teran-Ellis,Santiago Mier y
Cuen-Ojeda,Cesar
Arzola-Flores,Luis H.
Anaya-Ayala,Javier E.
Hinojosa,Carlos A.
Analysis of clinical outcomes of arteriovenous fistula for hemodialysis access in a Mexican elderly population
author_facet Contreras-Jimenez,Emmanuel
Lopez-Pena,Gabriel
Ruben-Castillo,Christopher
Teran-Ellis,Santiago Mier y
Cuen-Ojeda,Cesar
Arzola-Flores,Luis H.
Anaya-Ayala,Javier E.
Hinojosa,Carlos A.
author_sort Contreras-Jimenez,Emmanuel
title Analysis of clinical outcomes of arteriovenous fistula for hemodialysis access in a Mexican elderly population
title_short Analysis of clinical outcomes of arteriovenous fistula for hemodialysis access in a Mexican elderly population
title_full Analysis of clinical outcomes of arteriovenous fistula for hemodialysis access in a Mexican elderly population
title_fullStr Analysis of clinical outcomes of arteriovenous fistula for hemodialysis access in a Mexican elderly population
title_full_unstemmed Analysis of clinical outcomes of arteriovenous fistula for hemodialysis access in a Mexican elderly population
title_sort analysis of clinical outcomes of arteriovenous fistula for hemodialysis access in a mexican elderly population
description Abstract Objective. The increased survival rates of end-stage renal disease (ESRD) patients have impacted directly in the proportion of elderly patients requiring a reliable hemodialysis (HD) access; this group clearly demands an individualized approach. We aim to analyze maturation and patency rates of arteriovenous fistulas (AVF) in elderly patients. Methods. This was retrospective review of a database of patients that underwent AVF creation in our institution. The maturation and patency rates were analyzed divided in groups based on age (equal and greater of 65 years, and patients under 65 years). Patency rates were compared using Kaplan-Meier analysis. Results. Twenty patients ≥ 65 years old (mean 73, SD ± 5.4) were analyzed. The overall maturation rate in this group was 75% compared to 84.1% (p = 0.33) in the younger group (mean age 48 years, SD ± 17). The primary patency at 6 and 12 months for the ≥ 65 years group was 93% and 86%, respectively, compared with 85% and 81% for the younger group (p = 0.77). Conclusion. Autogenous AVF remains the preferred and durable option for elderly patients. We found no difference in terms of maturation and patency rates compared to younger patients. Standardized protocols are needed to optimally select vascular accesses.
publisher Academia Mexicana de Cirugía A.C.
publishDate 2023
url http://www.scielo.org.mx/scielo.php?script=sci_arttext&pid=S2444-054X2023000200200
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