L'accesso vascolare nell'anziano: confronto FAV versus CVCp, commento.

Translated title of the contribution: [Vascular access in the elderly: AVF vs CVC. A comment].

S. V. Bertoli, C. Musetti

Research output: Contribution to journalArticle

Abstract

The aging population starting hemodialysis treatment raises the question as to which is the best vascular access in an older patient with multiple complications. The center effect is an important element in the choice of a vascular access, as shown by the DOPPS data and by a recent audit held in Lombardy. However, other data show an increase in the use of permanent CVCs in the last years and other factors must be taken into account in this clinical choice. Also the timing of proposing a vascular access to a patient has changed over the years (see K-DOQI 2006 vs 2000). Most of the literature agrees on the strategy of a global clinical evaluation of the patient to decide when to place a vascular access and which type of access to use. Native and prosthetic fistulas are considered superior to CVCs although the latter have certain advantages in selected patients, such as those with severe cardiac problems. The nephrologist has a major role in vascular access management as part of a team made up also by a vascular surgeon and an interventional radiologist. Only in a center where both native and prosthetic fistulas can be constructed and permanent CVCs be placed can a nephrologist choose the most appropriate vascular access for individual patients after evaluation not only of their renal function but their cardiovascular risk as well.

Original languageItalian
Pages (from-to)625-627
Number of pages3
JournalGiornale italiano di nefrologia : organo ufficiale della Società italiana di nefrologia
Volume25
Issue number6
Publication statusPublished - Nov 2008

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Blood Vessels
Fistula
Renal Dialysis
Kidney
Population

ASJC Scopus subject areas

  • Nephrology

Cite this

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