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Frailty and arteriovenous fistula patency in elderly hemodialysis patients: a retrospective cohort study
Polyana Bezerra Mendonça1, Rodrigo Bezerra1, Flávio Teles2
1Universidade Federal de Pernambuco, Recife, PE, Brazil.
Insights
Frailty is linked to assisted arteriovenous fistula (AVF) patency in elderly hemodialysis patients. Integrating frailty assessment into nursing protocols may improve care for this vulnerable population.
Area of Science:
- Nephrology
- Geriatrics
- Vascular Access
Background:
- Arteriovenous fistula (AVF) is a preferred vascular access for hemodialysis (HD).
- Frailty is a significant concern in elderly HD patients, potentially impacting outcomes.
- Understanding the relationship between frailty and AVF patency is crucial for optimizing patient management.
Purpose of the Study:
- To investigate the correlation between frailty status and AVF patency type in elderly patients undergoing hemodialysis.
- To identify if frailty influences the need for assisted AVF patency.
Main Methods:
- Retrospective cohort study of 89 elderly HD patients.
- Data collected included Clinical Frailty Scale (CFS), Charlson score, AVF site, patency type (primary vs. assisted), and mortality.
- Statistical analysis was performed to evaluate correlations.
Main Results:
- A positive correlation was observed between assisted AVF patency and frailty (p=0.043).
- Frail patients constituted 36% of the cohort and showed a higher prevalence of chronic kidney disease (CKD) and assisted AVF patency.
- Assisted AVF patency was more common in frail elderly patients.
Conclusions:
- Assisted AVF patency is significantly associated with frailty in elderly hemodialysis patients.
- Frailty assessment should be considered for integration into routine clinical evaluations by nurses in HD centers.
- This approach may aid in personalized care and improved outcomes for frail HD patients.
Objective:
To evaluate the correlation between frailty and AVF patency type in elderly patients in HD.
Methods:
This retrospective cohort study evaluated 89 patients from April 2019 to June 2022. The following data were analyzed: 1) Patient characteristics according to the Clinical Frailty Scale (CFS), 2) Charlson score, 3) AVF site (radiocephalic, brachiocephalic, basilic), 4) Patency type (primary and assisted), 5) Mortality. This study was approved by the Ethics Committee of the Oswaldo Cruz University Hospital - University of Pernambuco, under registration no. 4.487.269.
Results:
Among the 89 patients (age = 70 ± 8, 64% female, 36% frail), 42 (47%) had assisted AVF patency, with 26 (62%) being frail. A positive correlation was found between assisted patency and frailty (p = 0.043). During follow-up (548 to 938 days), 33 (37.1%) patients died, with frail patients showing a higher prevalence of CKD and a higher frequency of assisted patency.
Conclusion:
Assisted AVF patency was the most common type among frail elderly patients on hemodialysis. Frailty assessment may be integrated into the clinical evaluation protocol conducted by nurses at HD centers.
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