Predictive Parameters Functioning Arteriovenous Fistula for Hemodialysis in the Elderly

Elderly patients with end stage kidney disease represent a challenge for surgeons to create a vascular access.

Determine predictive parameters functionality of the arteriovenous fistulas for hemodialysis in the elderly.

The study was organized as a retrospective study at the Center for Dialysis, Clinic for Urology and Nephrology, Clinical Center Kragujevac. The study included patients older than 65 years with arteriovenous fistula thrombosis, in the period of four years, in which there is information on the length of the functioning fistula. The study included 48 patients, mean age 71.3±5.2 years, 29 (60%) men and 19 (40%) women. The data were analyzed according to gender and demographic structure, type of anastomosis, positioning, length of functioning fistulas, and the lumen diameter of the arteries and veins that are used to create a fistula.

The median length of functioning arteriovenous fistula, based on Kaplan-Meier model, is 16 months (95% CI 6.9-25.1). Median functioning for proximaly located fistulas was 24 months (range, 1-259), while median functioning in patient with distally located fistulas was 8 months (range, 1-96). The difference in relation to the positioning of the fistula was statistically significant (p=0.006). In univariate Cox regression model, a statistically significant predictor of the functioning of arteriovenous fistulae is fistula positioning (B=0.700; p=0.022).

The predictive parameter of survival of arteriovenous fistulas in elderly is proximally located fistula.