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Hemodialysis vascular access in the elderly-getting it right
Andrea K Viecelli1, Charmaine E Lok2
1Department of Nephrology, Princess Alexandra Hospital, Brisbane, Australia; Faculty of Medicine, University of Queensland, Brisbane, Australia.
Kidney International
|January 5, 2019
Summary
Optimizing hemodialysis vascular access for elderly patients requires a patient-centered, multidisciplinary approach. This strategy balances patient preferences, access longevity, and potential complications within their unique end-stage kidney disease Life-Plan.
Area of Science:
- Nephrology
- Geriatrics
- Vascular Surgery
Background:
- Elderly patients present unique challenges in selecting hemodialysis vascular access.
- Optimal access choice requires balancing patient preferences, access function, and potential complications.
Purpose of the Study:
- To present a framework for choosing optimal hemodialysis vascular access in elderly patients.
- To emphasize a patient-centered, multidisciplinary approach to this complex decision.
Main Methods:
- Review of current literature and clinical considerations for vascular access in the elderly.
- Framework incorporating patient's end-stage kidney disease Life-Plan, life expectancy, and access characteristics.
Main Results:
- A dynamic, patient-centered framework is crucial for selecting appropriate hemodialysis vascular access.
- Effective communication and consideration of individual patient circumstances are key.
Conclusions:
- Choosing hemodialysis vascular access for the elderly necessitates a coordinated, patient-centered, multidisciplinary team approach.
- Future research, including randomized controlled trials, is needed to refine evidence-based guidelines.
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