Molina AS, Gutiérrez GF, Orret CD

Language: Spanish
References: 13
Page: 25-33
PDF size: 178.46 Kb.

ABSTRACT

Introduction: In the last few years, the number of old patients in the hemodialysis service has increased. This fact along with this growing number of diabetic patients that show damaged vascular bed has brought about more difficulties in creating a vascular access in their risk population.
Objective: To observe the behavior of arteriovenous fistulae in patients aged 65 years or more subjected to hemodialysis.
Methods: Prospective, descriptive and observational study conducted in 65 years old and over whom an arteriovenous fistula was created from March 2011 to March 2013 at the hemodialysis service of the Institute of Nephrology in Havana. The study group was made up of 58 patients.
Results: The male sex predominated (55.2%). The most observed underlying diseases were diabetes mellitus (43.1%) and hypertension (37.9%). The most found complications were insufficient flow (15.2%) and thrombosis (12.1%). The highest survival rate was seen in arteriovenous fistulae in men (78%); non-diabetic patients (73%) and radiocephalic location (73%). The global primary survival rate after one year of the arteriovenous fistulae in our patients was 69%.
Conclusions: The autologous arteriovenous fistulae may be performed as a first option in patients aged 65 years or more, and adequate survival rates, comparable to those of other groups of patients, were reached.

REFERENCES

1. Waltzer WC. The surgical approache to dialysis access and transplantation in the elderly. Dial Transplant. 1991;20:123-7.

2. Pérez R, Dall’Anese C, Jofre R, López JM, Gómez FJ, Verde E, Valderrábano. Tratamiento sustitutivo de la función renal en diabéticos: 17 años de experiencia. Nefrología. 1996;16:56-8.

3. Ridao N, Polo JR, Pérez-García R, Sánchez M, Réngel MA, Gómez Campderá FJ. Accesos vasculares para diálisis en el anciano. Nefrología. 1998;18(S4).

4. Leapmann SB, Boyle M, Pescovitz MD, Milgrom ML, Jindal RM, Filo RS. The arteriovenous fistula for hemodialysis access. Gold standard or archaic relic? Am Surg. 1996;62:652-7.

5. Wing AJ, Brunner FP, Bryugre H. Continued report on regular dialysis and transplantation in Europe, Xl 1978. Proc Eur Dial Trans Assoc. 1979;13:2-52.

6. Graspa 1, Oreopoulos DG: Practical ethical issues of dialysis in the elderly. Semin Nephrol. 1996;16:339-52.

7. Polo JR, Lago M, Goicoechea M, Dall’Anese C, Serantes A, Sanabria J, Valentín C. Fístulas arteriovenosas para diálisis en el pliegue del codo. Nefrología. 1993; 13:60-5.

8. Graspa EJ, Paraskevopoulus AP, Moutafis SP, Vourliotou AJ, Papadoyannakis NJ, Digenis GE, Zerefos NJ. Complications of vascular Access in hemodialysis (HD)-aged vs adult patients. Geriatric Nephrology and Urology. 1998;8:21-4.

9. Bessias N, Paraskevas KI, Tziviskou E, Andrikopoulos V. Vascular access in elderly patients with end-stage renal disease. Int Urol Nephrol. 2008;40:1133-42.

10. Hinsdale JG, Lipcouvirtz GS, Hoover EL. Vascular access in the elderly: results and perspectives in a geriatric population. Dial Transplant. 1985;14:560-2.

11. Molina Alfonso S, Orret Cruz D, Pérez Rodríguez A, Gutiérrez García F. Supervivencia de las Fístulas Arteriovenosas en Pacientes en Hemodiálisis. Rev Cub Cir. 2012;51(4):307-17.

12. Miller CD, Robin ML, Alon M. Gender differences in outcomes of arteriovenous fistulas in hemodialysis patients. Kidney International. 2003;63:346-52.

13. Konner K. Primary vascular access in diabetic patients: an audit. Nephrol Dial Transplant. 2000;15:1317-25.