The Effect of Patient Age and Other Factors on the Maintenance of Permanent Hemodialysis Vascular Access

• Published in: Therapeutic apheresis and dialysis 2007-02, Vol.11 (1), p.36-41
• Main Authors: Hayakawa, Kunihiro, Miyakawa, Shinzaburo, Hoshinaga, Kiyotaka, Hata, Kenichi, Marumo, Ken, Hata, Makoto
• Format: Article
• Language: English
• Subjects: Adult; Age Factors; Aged; Aged, 80 and over; Arteriovenous Shunt, Surgical; Female; Humans; Male; Middle Aged; Multivariate Analysis; Patient age; Prognosis; Proportional Hazards Models; Renal Dialysis; Risk factor; Risk Factors; Survival rate; Vascular access
• ISSN: 1744-9979; 1744-9987
• DOI: 10.1111/j.1744-9987.2007.00453.x

:  The objective of the present study was to investigate whether patient age is associated with vascular access failure during maintenance hemodialysis. Thus, patients who had a successful permanent hemodialysis vascular access installed (Group N: 314 cases), and those who required vascular access revision (Group R: 108 patients) were studied. To assess the association between patient age and the risk of vascular access failure, Cox proportional hazards regression was used to determine hazard ratios (HR) and 95% confidence intervals (CI). We found that in Group N, the significant risk factors were age, gender, and diabetes mellitus (95% CI: 1.004–1.013, 0.380–0.827, 1.279–2.859). Using a univariate analysis model, significant hazard ratios (HR) were found with ages of 60 (CI: 1.062–2.302), 65 (CI: 1.052–2.280), and 70 (CI: 1.082–2.537) years, with the largest HR at 70 years of age (HR: 1.657). In contrast, in Group R, multivariate analysis using Cox proportional hazards identified only one prognostic variable, the location of the vascular access. In Group R, univariate analysis models showed that age was not a significant factor. We conclude that our data show that age is a risk factor for the successful maintenance of initial permanent hemodialysis vascular access. Other risk factors include gender and diabetes mellitus. However, these factors were not related to the successful maintenance of revised vascular access.