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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 J+Nephrol
2016 ; 29
(2
): 175-184
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English Wikipedia
The vascular access in the elderly: a position statement of the Vascular Access
Working Group of the Italian Society of Nephrology
#MMPMID26780568
Lomonte C
; Forneris G
; Gallieni M
; Tazza L
; Meola M
; Lodi M
; Senatore M
; Morale W
; Spina M
; Napoli M
; Bonucchi D
; Galli F
J Nephrol
2016[Apr]; 29
(2
): 175-184
PMID26780568
show ga
The incident hemodialysis (HD) population is aging, and the elderly group is the
one with the most rapid increase. In this context it is important to define the
factors associated with outcomes in elderly patients. The high prevalence of
comorbidities, particularly diabetes mellitus, peripheral vascular disease and
congestive heart failure, usually make vascular access (VA) creation more
difficult. Furthermore, many of these patients may have an insufficient
vasculature for fistula maturation. Finally, many fistulas may never be used due
to the competing risk of death before dialysis initiation. In these cases, an
arteriovenous graft and in some cases a central venous catheter become a valid
alternative form of VA. Nephrologists need to know what is the most appropriate
VA option in these patients. Age should not be a limiting factor when determining
candidacy for arteriovenous fistula creation. The aim of this position statement,
prepared by experts of the Vascular Access Working Group of the Italian Society
of Nephrology, is to critically review the current evidence on VA in elderly HD
patients. To this end, relevant clinical studies and recent guidelines on VA are
reviewed and commented. The main advantages and potential drawbacks of the
different VA modalities in the elderly patients are discussed.