Abstract
To evaluate the results of arteriovenous fistula (AVF) created for haemodialysis in patients older than 65 years of age. A retrospective analysis of patients with AVF or arteriovenous graft (AVG) creation, who were older than 65 years of age and were operated on at the II. Surgical Clinic at the University Hospital in Olomouc from 2014 - 2018 was performed. 212 patients were evaluated and a total of 239 AVF/AVG were created. 194 AVFs (81.18%) and 45 AVGs (18.82%) were created. Primary failure was seen in 19 arteriovenous fistulas (9.8%) and 2 arteriovenous grafts (4.44%). The primary patency of AVF was 69.9%, 62.8% after 12 and 24 months, respectively, and in the case of AVG it was 54.7% and 32.3% after 12 and 24 months, respectively. Primarily assisted patency of AVF was 77.6% and 66.3% after 12 and 24 months, respectively, and in case of AVG it was 69.1% and 39.7% after 12 and 24 months, respectively. Secondary patency of AVF was 77.6% and 66.3% after 12 and 24 months, respectively, and for AVG it was 69.1% and 39.7% after 12 and 24 months, respectively. The type of vascular access should be selected based on a thorough, protocol-based examination. In most seniors, AVF is the method of choice. The AVG is a suitable choice for patients with an exhausted venous bed, in acute need of haemodialysis, in the elderly and in females. A "customized" approach should be matter of fact for older generations.
Highlights
Hemodialysis (HD) is the most commonly used method in RRT – renal replacement therapy
The arteriovenous graft (AVG) is a suitable choice for patients with an exhausted venous bed, in acute need of haemodialysis, in the elderly and in females
A retrospective study evaluated all patients with end stage renal disease – ESRD, who were older than 65 years of age and AV creation was performed at the II
Summary
Hemodialysis (HD) is the most commonly used method in RRT – renal replacement therapy. Access for HD is ensured by a CVC - central venous catheter, arteriovenous fistula (AVF) or arteriovenous graft (AVG). Based on the current AVF guidelines, the method of choice is the fistula-first[1]. An arteriovenous graft (AVG) is indicated in patients with failed AVF, exhausted superficial venous bed or unsuitable vessels. The reported benefits of AVF in comparison with AVG are less obvious in older patients because the biological changes associated with age affect the results independently. Use of CVC is an easy approach to HD. It is associated with the highest incidents of complications and is primarily used for patients in the initial phases of HD, when there is no time to create an AV approach
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