대한신장학회

Skip Navigation: Skip to contents

KOR
ENG
전체메뉴보기

간행물 검색

현재 페이지 경로

HOME
간행물
간행물 검색

논문분류	춘계학술대회 초록집
제목	Age Is Not a Limiting Factor for Preemptive Arteriovenous Fistula Creation Before Hemodialysis to Improve Patient Survival
저자	Chang Min Park
출판정보	2025; 2025(1):
키워드	Elderly patients, Hemodialysis, Survival benifit, Arteriovenous access, Cental venous catheter
초록	Preemptive creation of an arteriovenous (AV) access before initiating hemodialysis reduces catheter dependency and provides clinical benefits. However, its effectiveness in elderly patients, particularly in the very elderly, such as octogenarians (> 80 years old), remains unclear. This study aimed to evaluate whether initiating hemodialysis with an AV access provides a survival benefit for elderly and very elderly patients, including octogenarians and nonagenarians (> 90 years old), using data from the Korean National Health Insurance Service (NHIS) database. We retrospectively analyzed patients who started hemodialysis between 2012 and 2021, categorized by initial vascular access: arteriovenous fistula (AVF), arteriovenous graft (AVG), or central venous catheter (CVC). Patients who initiated hemodialysis with an AV access were compared with those who started with a CVC and later underwent AV access creation. Subgroup analyses were conducted based on age, sex, and diabetes. Among 68,393 patients, 29,381 (42.96%) were in the initial AV group and 39,012 (57.04%) were in the CVC to AV group. Overall, the initial AV group had better survival than the CVC to AV group (adjusted hazard ratio [HR] 1.388, 95% confidence interval [CI] 1.353–1.424, p<0.001). In patients aged <80 years, the initial AV group showed a significant survival advantage (p<0.001). Among octogenarians, both initial AVF and AVG improved survival compared to CVC to AVF (HR 1.297, 95% CI 1.208–1.392, p<0.001) and CVC to AVG (HR 1.232, 95% CI 1.122–1.354, p<0.001), particularly in diabetic patients. In nonagenarians, initial AVF showed no survival benefit (HR 0.928, 95% CI 0.673–1.279, p=0.648), whereas initial AVG improved survival (HR 1.593, 95% CI 1.064–2.386, p=0.024). Preemptive AV access creation should be considered for elderly and very elderly pre-dialysis patients, particularly diabetic octogenarians. Age should not be a limiting factor for AV access creation before hemodialysis.
원문(PDF)	PDF 원문보기

목록

위로가기