Experience with Arteriovenous Fistula in Elderly Patients with Chronic Kidney Disease
Bibliographic record
Abstract
OBJECTIVES: In recent years, advances in medical care have expanded the boundaries of aging, leading to an increasing number of elderly individuals requiring hemodialysis (HD). The use of arteriovenous (AV) fistulas for HD in elderly patients remains controversial due to concerns about life expectancy, vascular aging, and comorbidities. This study aimed to compare AVF outcomes in patients aged ≥ 70 years with those aged < 70 years to evaluate the safety and efficacy of AVFs in elderly patients. MATERIALS AND METHODS: This retrospective, single-center study included 202 patients who underwent AVF creation for end-stage kidney disease between 2022 and 2024. Patients were divided into two groups: ≥ 70 years (n = 76) and < 70 years (n = 126). AVF maturation, complication rates, the need for new AVF, and primary and secondary patency rates were compared. Kaplan-Meier analysis and the log-rank test were used to assess patency outcomes. RESULTS: AVF maturation rates were comparable between the ≥ 70 years group (50.0%) and the < 70 years group (56.9%) (p = 0.330). The need for a new AVF within 6 months was 11.2% in the ≥ 70 years group and 17.6% in the < 70 years group (p = 0.387). There were no significant differences in late complications (p = 0.157), AVF location preferences (p = 0.450), or secondary intervention rates (p = 0.967). Kaplan-Meier analysis revealed no significant difference in primary (p = 0.411) or secondary (p = 0.432) patency between the two groups. CONCLUSION: Despite age-related concerns, AVF outcomes in elderly patients were comparable to those in younger individuals. AVFs should be considered a viable vascular access option for HD in elderly patients, provided that patient-specific factors are taken into account.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".