Frailty and arteriovenous fistula patency in elderly hemodialysis patients: a retrospective cohort study

Abstract

Objective: To evaluate the correlation between frailty and AVF patency type in elderly patients in HD. Methods: This retrospective cohort study evaluated 89 patients from April 2019 to June 2022. The following data were analyzed: 1) Patient characteristics according to the Clinical Frailty Scale (CFS), 2) Charlson score, 3) AVF site (radiocephalic, brachiocephalic, basilic), 4) Patency type (primary and assisted), 5) Mortality. This study was approved by the Ethics Committee of the Oswaldo Cruz University Hospital – University of Pernambuco, under registration no. 4.487.269. Results: Among the 89 patients (age = 70 ± 8, 64% female, 36% frail), 42 (47%) had assisted AVF patency, with 26 (62%) being frail. A positive correlation was found between assisted patency and frailty (p = 0.043). During follow-up (548 to 938 days), 33 (37.1%) patients died, with frail patients showing a higher prevalence of CKD and a higher frequency of assisted patency. Conclusion: Assisted AVF patency was the most common type among frail elderly patients on hemodialysis. Frailty assessment may be integrated into the clinical evaluation protocol conducted by nurses at HD centers.