I Hate Dialysis Message Board
Dialysis Discussion => Dialysis: General Discussion => Topic started by: petertohen on November 13, 2017, 07:10:07 PM
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I was wondering if anyone here has had experience with a fistula, or other vascular access for an elderly patient. My grandmother is 87, and the nephrologist has recommended using the subclavian catheter as a permanent solution. However, the dialysis center staff keeps asking about when we are getting a fistula or graft. Has anyone had experience with a permenant access for someone in their 80s or 90s? :Kit n Stik; :Kit n Stik;
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A catheter is the fast way to get started but not considered a permanent solution. Depending on comorbidities and how good her veins are, a cath might be “good enough.” It wouldn’t hurt to get evaluated by a vascular surgeon.
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A cath always has a greater risk of infection than we have with a fistula or graft. Granted, there is always a % of risk with sticking anything into a body.
The argument is with a cath there is not only the opening in the skin but the placement of the end of the cath being so much closer to the heart that a possible contamination could easily reach the heart much quicker than a contamination at skin level.
Most Vascular Surgeons will advise to have a fistula or graft placed as soon as possible so the cath may be removed. Here again, this depends on the condition of the patients veins and other possible health issues.
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The clinics are rated by CMS and one of the criteria is percentage of patients with Fistulas. I used to sit next to a tiny women in my clinic in New Jersey her veins and arteries were not considered suitable for a fistula. So she used a cath fo over 20 years. She has gone on to a better place, she moved to the beach in Deleware.
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I used to sit next to a tiny women in my clinic in New Jersey her veins and arteries were not considered suitable for a fistula. So she used a cath fo over 20 years. She has gone on to a better place, she moved to the beach in Deleware.
That's a nice positive short story...