Vascular Access Outcome in the Elderly Dialysis Patient in Combination With the Quality of Life

Abstract

Purpose: We performed a retrospective study on hemodialysis fistulae in patients aged 75 years and older. Methods: Dialysis records of 2 hospitals were searched for patients of 75 years and older who had primary autologous radiocephalic arteriovenous fistulae (RCAVFs) and brachiocephalic arteriovenous fistulae (BCAVFs). Outcome measures were primary, primary-assisted, and secondary patency rates. Also, quality of life (QOL) was measured. Results: A total of 107 fistulae were placed in 90 patients; 65 (61%) RCAVFs and 42 (39%) BCAVFs were created. The primary patency rate ( P = .026) and the primary-assisted patency rate ( P = .016) of BCAVFs were significantly higher than that of RCAVFs. Secondary patency rates at 1 year ( P = .01) and 2 years ( P = .035) were higher in BCAVFs than in RCAVFs. Conclusions: The BCAVFs give significantly higher primary and primary-assisted patency rates and also significantly higher secondary patency rates at 1 and 2 years. Therefore, we suggest the placement of elbow fistulae in the elderly patients. The QOL was surprisingly high in this population despite a high mortality rate.