Document Detail


Perforating vein fistula is superior to forearm fistula in elderly haemodialysis patients with diabetes and arterial hypertension.
MedLine Citation:
PMID:  21325347     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: Access-related problems are one of the major causes of morbidity in elderly patients with chronic kidney disease. The aim of this study was to assess potential risks and benefits in elderly patients comparing forearm arteriovenous fistula (AVF) and perforating vein AVF below the elbow for primary vascular access. METHODS: A retrospective comparison of elderly patients (65.7 ± 9.3 years, 70.4% male patients, 36.2% late referral) undergoing primary vascular access surgery using forearm AVF (n = 50) and perforating vein AVF (n = 55) was performed over a 2-year period, including a multivariate analysis of potential risk factors and benefits of primary patency (PP = intervention-free access survival) and secondary patency (SP = access survival until abandonment). RESULTS: Patency rates after 24 months were significantly higher in patients with perforating vein AVF (PP + SP: 78.2%) compared to forearm AVF (PP: 62%, SP: 56%, P = 0.04). Presence of diabetes mellitus in patients with forearm AVF was associated with a decreased PP [odds ratio (OR): 3.6, 95% confidence interval (CI): 0.9-13.8] and SP (OR: 4.8, 95% CI: 1.3-17.9), and arterial hypertension was associated with a lower PP (OR: 6.7, 95% CI: 0.8-53.9), whereas the presence of hyperparathyroidism was associated with higher PP and SP (OR: 0.2, 95% CI: 0.1-0.7). In contrast, PP and SP in patients with perforating vein AVF were not influenced by comorbidities. CONCLUSIONS: Perforating vein AVF is superior to forearm AVF in elderly patients with diabetes and arterial hypertension due to the proximal fistula location, probably caused by an improved artery distensibility during fistula maturation.
Authors:
Daniel Palmes; Linus Kebschull; Roland M Schaefer; Friedrich Pelster; Klaus Konner
Related Documents :
8782337 - Leaking giant aneurysm of the aortic root due to cystic medial necrosis with pericardia...
16234617 - Endovascular stent-graft placement for complications of acute type b aortic dissection.
21235627 - Reduction of the sinotubular junction in patients undergoing ascending aortic replaceme...
10946027 - Angiographic and clinical outcome of mild to moderate nonocclusive unstented coronary a...
20670557 - Effectiveness and pitfall of embolization of cerebral arteriovenous malformations.
19588307 - Traumatic vertebral artery aneurysm following blunt suboccipital trauma.
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-2-16
Journal Detail:
Title:  Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association     Volume:  -     ISSN:  1460-2385     ISO Abbreviation:  -     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-2-17     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8706402     Medline TA:  Nephrol Dial Transplant     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
1Interdisciplinary Vascular Access Centre, University of Muenster, Muenster, Germany.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Performance of an implantable automatic atrial fibrillation detection device: impact of software adj...
Next Document:  Anaemia and resistance to erythropoiesis-stimulating agents as prognostic factors in haemodialysis p...