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Evaluating the Function of the Foot Core System in the Elderly

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Planning and evaluation for vascular access in the elderly.

Candice Halinski¹, Holly M Koncicki²

¹Department of Medicine, Hofstra Northwell School of Medicine, Hempstead, NY, USA.

Seminars in Dialysis

|May 9, 2018

Summary

Vascular access is crucial for dialysis. This review examines arteriovenous fistula (AVF) placement in elderly patients, suggesting the "fistula first" approach may not always be ideal for this complex population.

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Area of Science:

Nephrology
Vascular Surgery
Geriatrics

Background:

Vascular access is essential for patients undergoing dialysis therapies.
Arteriovenous fistulas (AVFs) are the preferred vascular access method recommended by professional societies.
Access failure is a significant complication, particularly in an aging and medically complex patient population.

Purpose of the Study:

To review vascular access considerations for AVF placement specifically in the elderly population.
To evaluate the appropriateness of the "fistula first" approach for older patients requiring dialysis.

Main Methods:

Review of existing literature and clinical guidelines on vascular access for hemodialysis.
Analysis of factors influencing AVF outcomes in elderly patients.
Discussion of alternative vascular access options and decision-making processes.

Main Results:

Elderly patients present unique challenges for AVF creation and maintenance.
Access failure rates and complications may be higher in this demographic.
Careful consideration of individual patient factors is necessary before AVF placement.

Conclusions:

The "fistula first" strategy requires careful reflection in the elderly population.
Individualized vascular access planning is crucial for optimizing dialysis treatment outcomes in older adults.
Alternative access modalities should be considered when AVF is not optimal.