Hemodialysis vascular access in elderly patients: A comprehensive review

J Vasc Access. 2024 Jan;25(1):27-39. doi: 10.1177/11297298221097233. Epub 2022 May 12.

Abstract

The number of elderly patients initiating hemodialysis (HD) increased considerably over the past decade. Arteriovenous fistulas (AVFs) are the preferred vascular access (VA) type in most HD patients. Choice of VA for older hemodialysis patients presents a challenge. The higher incidence of comorbidities, longer AVF maturation times, risk of primary failure, risk of patency loss, and shorter life expectancy are important factors to consider. In this review we provide a comprehensive analysis on maturation rates, primary failure, patency, and mortality regarding vascular access in patients older than 75 years of age.

Keywords: Vascular access; arteriovenous fistula; arteriovenous graft; central venous catheter; elderly; hemodialysis; mortality; patency loss; primary failure.

Publication types

  • Review

MeSH terms

  • Aged
  • Arteriovenous Shunt, Surgical* / adverse effects
  • Humans
  • Kidney Failure, Chronic* / diagnosis
  • Kidney Failure, Chronic* / therapy
  • Renal Dialysis
  • Retrospective Studies
  • Treatment Outcome
  • Vascular Patency