Evaluation of the importance of age and gender in the patency of upper extremity arteriovenous fistula in chronic hemodialysis patients

Background: Arteriovenous fistula is the vascular access of the first choice in hemodialysis. Studies on the patency of the arteriovenous fistula and the influencing factors indicate that there is a high risk for access failure. The patency of arteriovenous fistulas is the primary determinant of the effectiveness of dialysis. Methods: Between April 2015 and July 2019, 161 patients (78 males, 83 females; mean age 61.1 years; range 35 to 75 years) who underwent AV fistula operation were retrospectively analyzed. The surgical operations were performed by two different cardiovascular surgeons for hemodialysis. The patients were divided into two groups including Group I (patients over 50 years of age; n=83; mean age 61.4 years) and Group II (patients under 50 years of age; n=78; mean age 60.8 years). Primary patency was the time interval between arteriovenous fistula creation and its first thrombosis and any intervention for recanalization. The effects of age and gender on primary patency rates were investigated in both groups. Results: In terms of arteriovenous fistula patency, primary fistula patency was lower in male patients. In addition, fistula patency was lower in Group I patients than in Group II patients during 5 years of follow-up (p<0.001). Conclusion: Arteriovenous fistula patency rates were lower in male patients over 50 years of age. The older age and male gender were found to be factors affecting the primary patency of arteriovenous fistulas.