Vascular access in elderly patients with end-stage renal disease.
During the last few years, the number of elderly patients with end-stage renal disease (ESRD) has been increasing worldwide. Establishment of a viable vascular access is of primary importance in these patients. This review discusses the advantages and disadvantages of the available vascular access modalities [namely arteriovenous (AV) fistulae, AV grafts, and central venous catheters (CVCs)] in elderly ESRD patients. AV fistulae seem to be superior when compared with other vascular access alternatives with respect to patency, morbidity and mortality rates. On the other hand, due to the age-related advanced atherosclerosis in the elderly, higher failure rates for AV fistulae in this age group have been described. Two controversial issues, namely the higher infection and thrombosis rates in elderly ESRD patients, are also discussed. Current evidence suggests that old age should not comprise a drawback when selecting the appropriate vascular access modality (AV fistula, AV graft or CVC) for the performance of hemodialysis. The possible vascular access options in elderly ESRD patients should not be different from younger individuals.
Bessias
Nikolaos
N
Department of Vascular Surgery, "Red Cross" Hospital, 24, Papagou Street, N. Iraklio, Athens, 14122, Greece.
Paraskevas
Kosmas I
KI
Tziviskou
Effie
E
Andrikopoulos
Vassilios
V
D000368:Aged; D000369:Aged, 80 and over; D001166:Arteriovenous Shunt, Surgical / Q000009:adverse effects; D002405:Catheterization, Central Venous / Q000009:adverse effects; D002408:Catheters, Indwelling / Q000009:adverse effects; D003657:Decision Making; D006083:Graft Occlusion, Vascular / Q000209:etiology / Q000517:prevention & control; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy*; D018579:Patient Selection; D017410:Practice Guidelines as Topic; D006435:Renal Dialysis / Q000379:methods*; D012307:Risk Factors; D014654:Vascular Patency
Artif Organs. 1998 Nov;22(11):945-7
9821527
Arch Surg. 2004 Feb;139(2):201-8
14769581
Blood Purif. 2002;20(6):563-8
12566673
Nephron. 2002 Jul;91(3):399-405
12119469
J Vasc Access. 2001 Jul-Sep;2(3):110-3
17638271
J Am Soc Nephrol. 2005 May;16(5):1449-55
15788468
Int Urol Nephrol. 2007;39(2):679-83
17522961
Int Urol Nephrol. 2006;38(3-4):821-7
17096077
J Korean Med Sci. 2006 Apr;21(2):284-9
16614515
Semin Dial. 2001 Nov-Dec;14(6):411-5
11851925
J Am Soc Nephrol. 1995 Dec;6(6):1613-8
8749688
Am J Nephrol. 1998;18(2):96-100
9569949
Blood Purif. 2005;23(2):101-5
15640601
Nephrol Dial Transplant. 1999 Jul;14(7):1651-7
10435872
Am J Kidney Dis. 1995 Aug;26(2):341-6
7645539
ASAIO J. 2003 Jul-Aug;49(4):435-9
12918587
Ann Intern Med. 1978 Jan;88(1):28-33
619755
Clin Infect Dis. 2003 Jun 15;36(12):1539-44
12802753
MMWR Morb Mortal Wkly Rep. 2008 Mar 28;57(12):309-12
18368005
J Vasc Surg. 2007 Feb;45(2):420-426
17264030
Br J Surg. 1999 Feb;86(2):211-6
10100789
Nephrol Nurs J. 2007 Mar-Apr;34(2):234-41
17486957
Blood Purif. 2001;19(2):251-4
11150819
J Vasc Surg. 2008 Jan;47(1):144-50
18178467
WMJ. 2005 Nov;104(8):66-71
16425925
Am J Surg. 1986 Aug;152(2):238-43
3740363
Clin J Am Soc Nephrol. 2008 Mar;3(2):369-74
18308996
Kidney Int. 1988 Jun;33(6):1156-9
2969991
Kidney Int. 1998 Oct;54(4):1029-40
9767519
Cardiovasc Surg. 2003 Feb;11(1):35-41
12543570
Semin Dial. 2007 Nov-Dec;20(6):606-10
17991212
Am J Nephrol. 2007;27(1):24-9
17215571
J Am Soc Nephrol. 2001 Dec;12(12):2753-2758
11729245
Ther Apher Dial. 2005 Jun;9(3):250-3
15967000
Int Urol Nephrol. 2006;38(3-4):795-800
17221285
Nephrol Dial Transplant. 2007 Feb;22(2):477-83
17018541
Int Urol Nephrol. 2006;38(2):371-9
16868714
Blood Purif. 2001;19(4):401-7
11574737
J Ren Care. 2008 Jun;34(2):101-8
18498575
J Am Soc Nephrol. 1998 Jun;9(6):1085-92
9621293
Am Surg. 1996 Aug;62(8):652-6; discussion 656-7
8712563
Child Nephrol Urol. 1991;11(4):212-4
1777904
N Z Med J. 2004 Jun 04;117(1195):U904
15282618
Int Urol Nephrol. 2006;38(3-4):801-9
17089215
J Nephrol. 2006 May-Jun;19(3):265-79
16874685
Adv Perit Dial. 1994;10:206-9
7999829
Kidney Int. 2001 Oct;60(4):1443-51
11576358
ASAIO J. 1992 Jul-Sep;38(3):M528-31
1457917
Eur J Vasc Endovasc Surg. 2000 Jan;19(1):70-6
10706839
Ren Fail. 2003 May;25(3):431-8
12803506
Int Urol Nephrol. 2006;38(3-4):759-65
17245550
Kidney Int. 1977 Jan;11(1):71-5
839655
Am J Kidney Dis. 2005 Sep;46(3):501-8
16129212
Semin Dial. 2006 Nov-Dec;19(6):543-50
17150058
Nephrol Dial Transplant. 2004 Jun;19(6):1546-51
14993498
Nephrol Dial Transplant. 2007 Sep;22(9):2601-4
17557776
Geriatr Nephrol Urol. 1998;8(1):21-4
9650044
N Engl J Med. 1999 Jan 7;340(1):1-8
9878638
Nephrol Dial Transplant. 1993;8(3):235-9
8385291
N Engl J Med. 1966 Nov 17;275(20):1089-92
5923023
Kidney Int. 2003 Jan;63(1):323-30
12472799
Am J Kidney Dis. 1994 Aug;24(2):316-20
8048439
Kidney Int. 1991 Nov;40(5):934-8
1762298
Nephrol Dial Transplant. 1998;13 Suppl 7:73-7
9870443
Am J Surg. 2004 Nov;188(5):614-6
15546582
Arch Surg. 2006 Jan;141(1):27-32; discussion 32
16415408
Am J Kidney Dis. 1992 Mar;19(3):214-34
1553966
J Surg Res. 1996 Feb 1;60(2):312-6
8598660
Am J Kidney Dis. 2007 Feb;49(2):276-83
17261430
Int Urol Nephrol. 2006;38(3-4):787-93
17160631
Adv Ren Replace Ther. 1994 Jul;1(2):148-54
7614314
Kidney Int. 2005 Jun;67(6):2462-9
15882293
Ann Intern Med. 2005 Oct 18;143(8):570-80
16230723
J Am Soc Nephrol. 2005 Dec;16(12):3736-41
16267160
J Am Soc Nephrol. 2004 Jan;15(1):204-9
14694174
Nephrol Dial Transplant. 2004 Aug;19(8):2044-52
15173379
Ann Intern Med. 1997 Aug 15;127(4):257-66
9265424
Nephrol Dial Transplant. 2001 Jul;16(7):1521-2
11427666
Am J Kidney Dis. 2001 Jan;37(1 Suppl 1):S137-81
11229969
J Am Soc Nephrol. 2003 Jan;14(1):169-79
12506149
Am J Kidney Dis. 1997 Jul;30(1):50-7
9214401
Am J Kidney Dis. 2003 Nov;42(5):1013-9
14582045
Int J Artif Organs. 2001 Apr;24(4):208-11
11394701
Semin Dial. 2002 Mar-Apr;15(2):91-3
11952933
Am J Kidney Dis. 2002 Dec;40(6):1264-76
12460046