Angioaccess for hemodialysis in patients 65 years and older

Abstract

With acceptance of older patients with end-stage renal disease (ESRD) for maintenance dialysis therapy, vascular access has become a critical link in successful renal replacement. Yet, in all age groups, complications associated with the creation and prolonged use of vascular access have contributed to the increased morbidity and cost of end-stage renal disease therapy [1]. We wondered if certain problems affected only the more elderly population who needed angioaccess for maintenance hemodialysis. Many have thought that the natural aging of the cardiovascular and epidermal systems plays a significant role in the development of complications following vascular access procedures in older uremic patients [2–4]. However, this assumption is not yet supported by the few surgical reviews that concentrate on the mobidity associated with vascular access in older patients [5, 6].