Vascular access for elderly hemodialysis patients: what should we aim for?

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Hugo Ferreira1, Luis Coentrao2

  • 1Nephrology Department, Hospital S. Joao, Porto - Portugal.

The Journal of Vascular Access
|March 9, 2016
PubMed

Insights

Elderly hemodialysis patients benefit from arteriovenous access, despite high failure rates. Careful evaluation ensures arteriovenous access is a viable strategy, offering superior outcomes compared to dialysis catheters for this growing population.

Area of Science:

  • Nephrology
  • Vascular Surgery
  • Geriatrics

Background:

  • Elderly patients with chronic kidney disease (CKD) represent a rapidly expanding demographic undergoing hemodialysis (HD).
  • This population experiences high rates of overall mortality and arteriovenous fistula failure.
  • Current vascular access policies may require re-evaluation for elderly HD patients.

Purpose of the Study:

  • To review the current literature on vascular access strategies for elderly patients with chronic kidney disease undergoing hemodialysis.
  • To assess the outcomes of different vascular access methods in this specific patient group.

Main Methods:

  • A systematic literature search was conducted on PubMed for English-language articles published between 2000 and 2015.
  • Studies focusing on vascular access-related outcomes in elderly CKD patients were included in the review.

Main Results:

  • Limited research indicates elderly CKD patients may undergo excessive vascular access procedures.
  • Arteriovenous access is a feasible option for elderly patients with proper vascular evaluation.
  • Outcomes associated with arteriovenous access for dialysis are superior to those of dialysis catheters.

Conclusions:

  • Physicians must consider CKD progression, patient life expectancy, and quality of life when deciding on arteriovenous access for elderly patients.
  • The likelihood of successful arteriovenous access creation should also be factored into the decision-making process.
Abstract

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