[Problem of creation of arteriovenous fistulae for hemodialysis in older patients].

INTRODUCTION

A significant problem in elderly on hemodialysis is vascular access creation. The aim of the study was to determine the factors of functionality of arteriovenous fistulas in elderly people.

MATERIAL AND METHODS

Target groups in the four-year study were patients over 65 years of life. The authors analyzed the demographic structure, the etiology of kidney weakness, the type of anastomosis, arteriovenous fistula location, use of catheters from hemodialysis, blood pressure and size of the lumen of blood vessels used for anastomosis. Routine hematological and biochemical parameters were determined in all subjects. The study included 120 patients, 42 (35%) women and 78 (65%) men.

RESULTS

Functional arteriovenous fistulae were found in 62 (51.70%) patients, aged 72.5 +/- 4.23 years and nonfunctional ones in 58 (48.3%) respondents aged 72 +/- 5.09 years. A significant difference between the studied groups was reached in relation to the type of anastomosis (p = 0.005) and sites of the located fistulas (p = 0.03). Hypertensive nephropathy occurs statistically significantly more frequently in patients with functional fistula (p = 0.03). Sedimentation (p = 0.01), hemoglobin (p = 0.04), platelets (p = 0.003), total cholesterol (p = 0.04) and low density lipoproteins (p = 0.03) had statistically higher values in patients with nonfunctional fistulae.

CONCLUSION

Atherosclerosis and increased coagulation in the old people on hemodialysis represent an important cause of complications of arteriovenous fistulae.