Pre-emptive angioaccess for haemodialysis in the elderly

Area of Science:

• Vascular Surgery
• Nephrology
• Geriatric Medicine

Background:

• The elderly population, especially those over 80, is rapidly growing in the UK.
• Pre-emptive angioaccess is crucial for initiating hemodialysis.
• Assessing age as a factor in angioaccess success is vital.

Purpose of the Study:

• To determine if age influences successful first dialysis through pre-emptive angioaccess.
• To identify risk factors for angioaccess failure.
• To compare patency and complication rates across different age groups.

Main Methods:

• Retrospective analysis of prospectively collected data (2006-2007).
• Patients divided into three age groups: <70 (A), 70-79 (B), and ≥80 (C).
• Kaplan-Meier curves and log-rank testing used to compare primary and secondary patency rates.

Main Results:

• Successful first dialysis rates were 88% (A), 71% (B), and 87% (C), with no significant difference (P > 0.05).
• Primary, assisted primary, and secondary patency rates showed no significant age-related differences at 12, 24, and 36 months (P > 0.05).
• Six deaths occurred before dialysis initiation.

Conclusions:

• Pre-emptive angioaccess is a viable first-line venous access for elderly patients.
• Age is not a significant determinant of angioaccess success or failure rates.
• Patients over 80 should undergo individualized assessment for pre-emptive angioaccess.