Kidney Week

Abstract: SA-PO947

Octogenarians in Pre-Dialysis Phase Do Not Have Worse Results of Radio Cephalic Arteriovenous Fistula Compared to Younger Patients

Session Information

• Dialysis: Vascular Access - II
  October 27, 2018 | Location: Exhibit Hall, San Diego Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Dialysis

• 704 Dialysis: Vascular Access

Authors

• Mauro, Raffaella, Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy

Raffaella Mauro,

• Abualhin, Mohammad, Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy

Mohammad Abualhin,

• Pini, Rodolfo, Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy

Rodolfo Pini,

• Croci Chiocchini, Anna Laura, Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy

Anna Laura Croci Chiocchini,

• Donati, Gabriele, Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy

Gabriele Donati,

• Pini, Alessia, Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy

Alessia Pini,

• Faggioli, Gianluca, Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy

Gianluca Faggioli,

• La Manna, Gaetano, Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy

Gaetano La Manna,

• Stella, Andrea, Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy

Andrea Stella,

• Gargiulo, Mauro, Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy

Mauro Gargiulo,

Background

KDOQI guidelines recommend radiocephalic arteriovenous fistula (RCAVF) as a first choice access for hemodialytic treatment, but there is no clear indication in octogenarians. The study aim was to compare the results of RCAVF in octogenarians and younger patients.

Methods

All patients treated by RCAVF from Jan-2013 to Dec-2017 were included in a retrospective study. The population was divided according to age: <80 years (Group-A: mean age 61 years ±15; 80.9% males) and ≥80 years (Group-B: mean age 83 years ±3; 91.8% males). Patient demographics, comorbidities, and dialytic treatment were collected prospectively. The endpoints were technical success, defined as AVF presenting vascular murmur and thrill at the end of operation, primary patency defined as patency of vascular access with no significant arterial/venous stenosis, and assisted patency defined as patency of vascular access following a salvage procedure (PTA or surgical).

Results

Within the study period, 366 RCAVF were performed. 72(19.6%) patients were lost to follow-up. A total of 294 RCAVF were analyzed: 249(83.3%) RCAVF were performed in Group-A and 49(16.7%) in Group-B. Technical success was obtained in 95.9% of cases with no differences between the two groups (P=0.70). The mean follow up was 25 months. Primary and assisted patency rates were significantly higher in Group A (P=0.002 and P=0.023, respectively). Primary patency rates at 12,24 and 36 months were respectively 77.5%,73.9% and 73.9% in Group-A and 66.0%,49.8% and 46.0% in Group-B. Assisted patency rates at 12,24 and 36 months were respectively 79.6%,76.5% and 75.8% in Group-A and 70.2%,62.4% and 54.8% in Group-B. At univariate analysis pre-dialytic phase was an independent positive predictor for patency in Group-B (P=0,013) but not in global population (P=0.66). Considering all patients in pre-dialytic phase, there was no significant difference in primary patency rates between Group-A and B (P=0.59). Considering the octogenarians, 81.6% RCAVF became functional within the first 3 months.

Conclusion

According to the study results, RCAVF is associated with good results in octogenarians in pre-dialytic phase with suitable anatomical features and could be indicated as a first choice treatment.