The importance of age in terms of fistula patency in chronic hemodialysis patients: 7-year follow-up

Abstract

Background: Patients with kidney failure need dialysis until transplant or die. Hemodialysis is one of the preferred methods for these patients. Many studies have been conducted on the factors affecting the patency of arteriovenous fistulas, which are frequently used for hemodialysis. In this study, we investigated the importance of age.

Methods: 442 patients (256 men, 186 women) who underwent arteriovenous fistula operation between May 2013 and Oct 2020 were retrospectively analyzed. Surgical operations were performed by 5 different cardiovascular surgeons for hemodialysis in two different institutions in our region. The patients were divided into two groups, Group I (number of patients under 40 years old; n = 201) and Group II (number of patients over 40 years old; n = 241). The primary patency was the time interval between the formation of arteriovenous fistula and any intervention for initial thrombosis and recanalization. Secondary patency was not evaluated in this study. The effects of age on primary exposure rates were investigated for both groups.

Results: Primary arteriovenous fistula patency rates were lower in patients over 40 years of age. For this reason, more care should be taken in surgery to create fistulas in patients over the age of 40, and the follow-up of patients should be done more tightly.

Conclusion: Complicated external hernias occur in all age groups but are more common in older age and show preponderance in males. All patients present with irreducible swelling with no cough impulse. The indirect inguinal hernia is the most common type and herniorrhaphy is the most preferred operative procedure in the complicated hernia. Wound sepsis was the most common complication. Morbidity and mortality may be attenuated with proper surgical and post-operative management.

Keywords: Arteriovenous fistula; hemodialysis; age; surgery; patency