I need an advice

[petertohen]

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?
http://ihatedialysis.com/

[LoneHighway]

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.

[Charlie B53]

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.

[Michael Murphy]

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.

[iolaire]

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...