BIOMAT Database Logo BIOMAT Database Logo

[Fistulae or catheter for elderly who start hemodialysis without permanent vascular access?]. 2005

Ma J García Cortés, and G Viedma, and M C Sánchez Perales, and F J Borrego, and J Borrego, and P Pérez del Barrio, and J M Gil Cunquero, and A Liébana, and V Pérez Bañasco
Servicios de Nefrología, Complejo Hospitalario de Jaén. mjgarciac@supercable.es

Autologous access is the best vascular access for dialysis also in older patients and it should be mature when patient needs hemodialysis. It is not always possible. Surgeon availability and demographic characteristics of patients (age, diabetes, vascular disease...) are factors that determine primary vascular access. OBJECTIVE To analyse outcome and vascular access complications in elderly who start hemodialysis without vascular access. METHODS All patients older than 75 years who initiated hemodialysis without vascular access between January 2000 and June 2002 were included, They were divided en two groups depending on primary vascular access. GI: arterio-venous fistulae. GIIl: Tunnelled cuffed catheter. Epidemiological and analytical data, vascular access complications related, as well as patient and first permanent vascular access survival from their inclusion in dialysis up to December 2002 were analysed and compared in both groups. RESULTS 32 patients were studied. GI: n = 17 (4 men) and GIIl: n =1 5 (8 men), age: 79.9 +/- 3.8 and 81.7 +/- 4 years respectively (ns). There were no differences in sex and comorbidity (diabetes, ischemic heart disease, peripheral vascular disease and hypertension). It took GI 3 months to get a permanent vascular access suitable for using, while it took GIIl 1.3 months (p < 0.005) The number of temporary untunnelled catheters was higher in GI (3.35 vs 1.87 p < 0.05). Vascular access complications: 70.6% of infections occur in GI (incidence (I) = 48 infections/100 patients-year) while only 29.4% were detected in GII (I = 25 infections/100 patients-year). 70% of central venous thrombosis happen in GI (I: 25 CVT/100 patients-year) vs 30% in GIIl (I = 14.4/100 patients-year) (ns). No significant differences neither in bleeding (66.7% vs 33.3%) nor ischemia (75% vs 25%) were found. Dialysis dose (Kt/V) as well as anaemia degree were similar in both groups. Permanent vascular access survival after 2 years was 45.8% in GI and 24% in GII (ns). Patient survival was similar in GI and GII (72% vs 51% ns). CONCLUSIONS Elderly who start hemodialysis without vascular access took longer to get a suitable permanent vascular access when arterio-venous fistulae is placed than with a tunnelled cuffed hemodialysis catheter. As a consequence, vascular access complications are larger, infection ones are the most common. In these patients a tunnelled catheter should be inserted at the time a peripheral arterio-venous access is created, in order to avoid temporary untunnelled catheters.

UI MeSH Term Description Entries
D007239 Infections Invasion of the host organism by microorganisms or their toxins or by parasites that can cause pathological conditions or diseases. Infection,Infection and Infestation,Infections and Infestations,Infestation and Infection,Infestations and Infections
D007511 Ischemia A hypoperfusion of the BLOOD through an organ or tissue caused by a PATHOLOGIC CONSTRICTION or obstruction of its BLOOD VESSELS, or an absence of BLOOD CIRCULATION. Ischemias
D007676 Kidney Failure, Chronic The end-stage of CHRONIC RENAL INSUFFICIENCY. It is characterized by the severe irreversible kidney damage (as measured by the level of PROTEINURIA) and the reduction in GLOMERULAR FILTRATION RATE to less than 15 ml per min (Kidney Foundation: Kidney Disease Outcome Quality Initiative, 2002). These patients generally require HEMODIALYSIS or KIDNEY TRANSPLANTATION. ESRD,End-Stage Renal Disease,Renal Disease, End-Stage,Renal Failure, Chronic,Renal Failure, End-Stage,Chronic Kidney Failure,End-Stage Kidney Disease,Chronic Renal Failure,Disease, End-Stage Kidney,Disease, End-Stage Renal,End Stage Kidney Disease,End Stage Renal Disease,End-Stage Renal Failure,Kidney Disease, End-Stage,Renal Disease, End Stage,Renal Failure, End Stage
D008297 Male Males
D011446 Prospective Studies Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group. Prospective Study,Studies, Prospective,Study, Prospective
D002318 Cardiovascular Diseases Pathological conditions involving the CARDIOVASCULAR SYSTEM including the HEART; the BLOOD VESSELS; or the PERICARDIUM. Adverse Cardiac Event,Cardiac Events,Major Adverse Cardiac Events,Adverse Cardiac Events,Cardiac Event,Cardiac Event, Adverse,Cardiac Events, Adverse,Cardiovascular Disease,Disease, Cardiovascular,Event, Cardiac
D002408 Catheters, Indwelling Catheters designed to be left within an organ or passage for an extended period of time. Implantable Catheters,In-Dwelling Catheters,Catheter, In-Dwelling,Catheter, Indwelling,Catheters, In-Dwelling,In Dwelling Catheters,In-Dwelling Catheter,Indwelling Catheter,Indwelling Catheters
D004868 Equipment Failure Failure of equipment to perform to standard. The failure may be due to defects or improper use. Defects, Equipment,Device Failure,Failure, Equipment,Malfunction, Equipment,Medical Device Failure,Misuse, Equipment,Device Failure, Medical,Device Failures, Medical,Failure, Medical Device,Failures, Medical Device,Defect, Equipment,Device Failures,Equipment Defect,Equipment Defects,Equipment Failures,Equipment Malfunction,Equipment Malfunctions,Equipment Misuse,Equipment Misuses,Failure, Device,Failures, Device,Failures, Equipment,Malfunctions, Equipment,Misuses, Equipment
D005260 Female Females
D006435 Renal Dialysis Therapy for the insufficient cleansing of the BLOOD by the kidneys based on dialysis and including hemodialysis, PERITONEAL DIALYSIS, and HEMODIAFILTRATION. Dialysis, Extracorporeal,Dialysis, Renal,Extracorporeal Dialysis,Hemodialysis,Dialyses, Extracorporeal,Dialyses, Renal,Extracorporeal Dialyses,Hemodialyses,Renal Dialyses

Related Publications

Ma J García Cortés, and G Viedma, and M C Sánchez Perales, and F J Borrego, and J Borrego, and P Pérez del Barrio, and J M Gil Cunquero, and A Liébana, and V Pérez Bañasco
[Permanent catheter as an alternative vascular access for hemodialysis].
January 1996, Przeglad lekarski,
Ma J García Cortés, and G Viedma, and M C Sánchez Perales, and F J Borrego, and J Borrego, and P Pérez del Barrio, and J M Gil Cunquero, and A Liébana, and V Pérez Bañasco
Use of the Hickman catheter as permanent vascular access for hemodialysis.
January 1990, ASAIO transactions,
Ma J García Cortés, and G Viedma, and M C Sánchez Perales, and F J Borrego, and J Borrego, and P Pérez del Barrio, and J M Gil Cunquero, and A Liébana, and V Pérez Bañasco
A new vascular access catheter for hemodialysis.
March 1993, American journal of kidney diseases : the official journal of the National Kidney Foundation,
Ma J García Cortés, and G Viedma, and M C Sánchez Perales, and F J Borrego, and J Borrego, and P Pérez del Barrio, and J M Gil Cunquero, and A Liébana, and V Pérez Bañasco
Complications from permanent hemodialysis vascular access.
October 1988, Surgery,
Ma J García Cortés, and G Viedma, and M C Sánchez Perales, and F J Borrego, and J Borrego, and P Pérez del Barrio, and J M Gil Cunquero, and A Liébana, and V Pérez Bañasco
Hemodialysis access without a shunt or catheter: the circulating port.
January 2007, The journal of vascular access,
Ma J García Cortés, and G Viedma, and M C Sánchez Perales, and F J Borrego, and J Borrego, and P Pérez del Barrio, and J M Gil Cunquero, and A Liébana, and V Pérez Bañasco
Permanent twin catheter: a vascular access option of choice for haemodialysis in elderly patients.
January 1998, Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association,
Ma J García Cortés, and G Viedma, and M C Sánchez Perales, and F J Borrego, and J Borrego, and P Pérez del Barrio, and J M Gil Cunquero, and A Liébana, and V Pérez Bañasco
[Axillary catheter for hemodialysis, an alternative vascular access].
January 2008, Nefrologia : publicacion oficial de la Sociedad Espanola Nefrologia,
Ma J García Cortés, and G Viedma, and M C Sánchez Perales, and F J Borrego, and J Borrego, and P Pérez del Barrio, and J M Gil Cunquero, and A Liébana, and V Pérez Bañasco
Vascular access for hemodialysis in the elderly.
April 2011, Journal of vascular surgery,
Ma J García Cortés, and G Viedma, and M C Sánchez Perales, and F J Borrego, and J Borrego, and P Pérez del Barrio, and J M Gil Cunquero, and A Liébana, and V Pérez Bañasco
Vascular access for hemodialysis in the elderly.
February 2019, Journal of vascular surgery,
Ma J García Cortés, and G Viedma, and M C Sánchez Perales, and F J Borrego, and J Borrego, and P Pérez del Barrio, and J M Gil Cunquero, and A Liébana, and V Pérez Bañasco
Maintenance of permanent hemodialysis vascular access patency.
February 1995, ANNA journal,
Copied contents to your clipboard!