Harford Rubette, Clark Mary Jo, Norris Keith C, Yan Guofen
Nephrol Nurs J. 2014 Sep-Oct;41(5):507-11, 518.
Placement of an arteriovenous fistula (AV) prior to initiating hemodialysis can affect clinical outcomes for patients who subsequently initiate chronic hemodialysis treatments. Age-related variation in receipt of a functioning A TF prior to initiating hemodialysis is not well known. The purpose of this study was to examine age-related rates in use of AVF at the first outpatient hemodialysis treatment among U.S. incident patients on hemodialysis.
Among 526,145 patients identified, the use of AVF outpatient hemodialysis treatment was lower in the youngest (younger than 55 years) and oldest (80 years and older) vs. both 55 to 66-year and 67 to 79-year age groups. These findings persisted after adjusting for demographics, lifestyle behavior, employment and insurance status, physical/functional conditions, and co-morbid conditions.
The presence of a functioning AVF at initial hemodialysis treatment varies by age. Modifying healthcare policy and/or expanding the role of nephrology nurses should be considered to address this issue.
在开始血液透析之前建立动静脉内瘘（AV）会影响随后开始接受慢性血液透析治疗患者的临床结局。在开始血液透析之前接受功能性动静脉内瘘（AVF）的年龄相关差异尚不明确。本研究的目的是调查美国首次接受血液透析的门诊患者在首次门诊血液透析治疗时使用AVF的年龄相关比率。
在526,145名确定的患者中，最年轻（小于55岁）和最年长（80岁及以上）患者在门诊血液透析治疗中使用AVF的比例低于55至66岁以及67至79岁年龄组。在对人口统计学、生活方式行为、就业和保险状况、身体/功能状况以及合并症进行调整后，这些结果依然存在。
初次血液透析治疗时功能性AVF的存在情况因年龄而异。应考虑修改医疗政策和/或扩大肾病护士的作用以解决这一问题。
