Der Hämodialysezugang für den alten Dialysepatienten – Was ist der geeignete Zugang und wie vermeidet man Komplikationen?

The vascular access for haemodialysis in the elderly raises substantial problems for surgeons and nephrologists. Nevertheless in elderly people native fistulas should be preferred over cuffed central venous catheters (CVC). In Germany, there is the problem that elderly are referred to nephrologists very late which results in higher rates of CVC. Another reason for this higher rate is restlessness in combination with dementia in elderly people. Native fistulas in the elderly are working quite well compared to younger patients. Age is therefore not a serious factor to prefer CVC. Preoperative dopplersonography is recommended to increase the success of creating native fistulas. Infectious complications of CVC can be diminished by observing strict hygienic rules and by using antimicrobial lock solutions containing Gentamycin, taurolidine and/or citrate.