title: Vascular access outcome in the elderly dialysis patient in combination with the quality of life.
abstract: OBJECTIVE
  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.
authors.affiliation: Department of Surgery, Amphia Hospital, Breda, The Netherlands. kevin_de_leur@hotmail.com
authors.forename: Kevin
authors.initials: K
authors.lastname: de Leur
authors.forename: Cigdem
authors.initials: C
authors.lastname: Oztürk
authors.forename: Michiel L P
authors.initials: ML
authors.lastname: Van Zeeland
authors.forename: Hans G W
authors.initials: HG
authors.lastname: de Groot
authors.forename: Jan M M
authors.initials: JM
authors.lastname: Heyligers
authors.forename: Patrick W H E
authors.initials: PW
authors.lastname: Vriens
authors.forename: Gwan H
authors.initials: GH
authors.lastname: Ho
authors.forename: Lijckle
authors.initials: L
authors.lastname: van der Laan
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001166:Arteriovenous Shunt, Surgical / Q000009:adverse effects / Q000401:mortality; D005260:Female; D006083:Graft Occlusion, Vascular / Q000209:etiology / Q000503:physiopathology / Q000523:psychology / Q000628:therapy; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D009426:Netherlands; D011788:Quality of Life; D006435:Renal Dialysis / Q000009:adverse effects / Q000401:mortality; D012086:Reoperation; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D014654:Vascular Patency
keywords: arteriovenous fistula; elderly patients; hemodialysis access surgery; quality of life