title: Patient survival following arteriovenous fistula formation.
abstract: OBJECTIVE
  Efforts to promote arteriovenous fistulas (AVFs) have been successful in increasing the prevalence of AVF use as the primary vascular access for haemodialysis (HD). Sustained preference for AVF use may not be the most appropriate vascular access choice for all patient groups. Arteriovenous grafts (AVGs) offer advantages of earlier use and lower primary failure rates compared to AVFs so may be preferable for patients where short-term vascular access is needed. This study was designed to assess comparative mortality in different age groups following AVF formation.
  
  
  METHODS
  A prospective cohort of patients having AVF creation was recruited. Patients were subdivided into three age groups: Group A: <50 years; Group B: 50-74 years and Group C: ≥75 years. Survival curves and Cox regression analysis were performed on each of these groups.
  
  
  RESULTS
  One hundred and thirty-four patients (n = 134) were recruited into the study. The prevalence of diabetes increased significantly with age. As expected, mortality was higher in older age groups (log rank (Mantel-Cox) 19.227; p = 0.0001). Mortality rates at 1 year were 0% in group A, 12.5% in group B and 29.1% in group C. Medium-term mortality at 4 years was 7.9% in group A, 39.1% in group B and 54.8% in group C.
  
  
  CONCLUSIONS
  We found a significantly higher mortality rate in patients ≥75 years in comparison to those <75 years. The choice of vascular access modality should be tailored to the individual with particular reference to the patient's expected survival.
authors: 1 Department of Vascular Access and Renal Transplantation, University Hospitals Birmingham, Queen Elizabeth Hospital, Edgbaston, Birmingham - UK.
authors: Damian G
authors: DG
authors: McGrogan
authors: Melanie A
authors: MA
authors: Field
authors: Alexander P
authors: AP
authors: Maxwell
authors: Yazin
authors: Y
authors: Marie
authors: Nicholas G
authors: NG
authors: Inston
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D001166:Arteriovenous Shunt, Surgical / Q000009:adverse effects / Q000401:mortality*; D015897:Comorbidity; D003920:Diabetes Mellitus / Q000401:mortality; D004739:England / Q000453:epidemiology; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D015995:Prevalence; D016016:Proportional Hazards Models; D011446:Prospective Studies; D006435:Renal Dialysis; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome