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Review
. 2016 Apr;29(2):175-184.
doi: 10.1007/s40620-016-0263-z. Epub 2016 Jan 16.

The vascular access in the elderly: a position statement of the Vascular Access Working Group of the Italian Society of Nephrology

Carlo Lomonte  1 , Giacomo Forneris  2 , Maurizio Gallieni  3 , Luigi Tazza  4 , Mario Meola  5   6 , Massimo Lodi  7 , Massimo Senatore  8 , Walter Morale  9 , Monica Spina  10 , Marcello Napoli  11 , Decenzio Bonucchi  12 , Franco Galli  13
Affiliations
Review

The vascular access in the elderly: a position statement of the Vascular Access Working Group of the Italian Society of Nephrology

Carlo Lomonte et al. J Nephrol. 2016 Apr.

Erratum in

Abstract

The incident hemodialysis (HD) population is aging, and the elderly group is the one with the most rapid increase. In this context it is important to define the factors associated with outcomes in elderly patients. The high prevalence of comorbidities, particularly diabetes mellitus, peripheral vascular disease and congestive heart failure, usually make vascular access (VA) creation more difficult. Furthermore, many of these patients may have an insufficient vasculature for fistula maturation. Finally, many fistulas may never be used due to the competing risk of death before dialysis initiation. In these cases, an arteriovenous graft and in some cases a central venous catheter become a valid alternative form of VA. Nephrologists need to know what is the most appropriate VA option in these patients. Age should not be a limiting factor when determining candidacy for arteriovenous fistula creation. The aim of this position statement, prepared by experts of the Vascular Access Working Group of the Italian Society of Nephrology, is to critically review the current evidence on VA in elderly HD patients. To this end, relevant clinical studies and recent guidelines on VA are reviewed and commented. The main advantages and potential drawbacks of the different VA modalities in the elderly patients are discussed.

Keywords: Arteriovenous fistula; Arteriovenous graft; Central venous catheter; Elderly; Vascular access.

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Conflict of interest statement

Ethical standards

The research does not involve human participants or animals.

Informed consent is not required.

Conflict of interest

The authors have no conflict of interest to declare.

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