EFFECTS OF AGE AND DIABETES ON BLOOD-FLOW RATE AND PRIMARY OUTCOME OFNEWLY CREATED HEMODIALYSIS ARTERIOVENOUS-FISTULAS

To study the feasibility of creating a radiocephalic hemodialysis fist ula in elderly and diabetic patients, we prospectively studied 176 pat ients undergoing the first permanent vascular access creation and foll owed the outcome of fistula until primary failure or success was asses sed. Color duplex ultrasonography was used to measure the blood flow r ate. Fistula blood flow rate was significantly smaller in elderly pati ents, however, it was >400 ml/min in over 78% of the elderly patients with successful fistulas. There was no difference in fistula blood flo w rate between nondiabetics and diabetics. Dialysis adequacy (Kt/V) vi a fistula was the same between age groups and between diabetes mellitu s status, Old age or diabetes per se did not significantly predispose a new fistula to primary failure, but concurrent old age and diabetes markedly increase the risk. In conclusion, a good primary outcome of n ewly created radiocephalic fistula and adequate dialysis via fistula w ere demonstrated for elderly and diabetic patients. However, the longe vity of fistula in elderly and diabetic patients needs further study.