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Vascular access for dialysis in the elderly.

¹Renal Service, Hospital Garcia de Orta, Almada, Portugal.

International Urology and Nephrology

|September 17, 2002

Summary

Elderly patients have high rates of vascular access failure. This review examines reasons for failure and proposes strategies to improve durable native arteriovenous fistula creation in this growing population.

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Area of Science:

Nephrology
Vascular Surgery
Geriatrics

Background:

The elderly population is rapidly expanding.
Vascular access in elderly patients presents unique challenges.
Current guidelines lack specific recommendations for elderly vascular access.

Purpose of the Study:

To review hemodynamic and endothelial mechanisms of vascular access failure in the elderly.
To analyze strategies for increasing the use of durable native arteriovenous fistulas in older adults.

Main Methods:

Literature review of hemodynamic and endothelial mechanisms.
Analysis of strategies for arteriovenous fistula creation.

Main Results:

Elderly patients exhibit a high morbidity and failure rate with current vascular access methods.
Specific hemodynamic and endothelial factors contribute to access failure in this demographic.

Conclusions:

Vascular access in the elderly requires specialized recommendations beyond current guidelines.
Implementing strategies to promote native arteriovenous fistulas can improve outcomes in elderly patients.

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