Hemodialysis in the elderly: vascular access and initiation of renal replacement therapy.

Elderly persons with kidney failure are faced with many important considerations. Factors contributing to the choice of vascular access are often related to issues that also affect the timing of initiation of dialysis. This article provides guidance in determining when elderly patients are likely to develop an increased risk for complications of chronic kidney failure and comorbid conditions, and should therefore assist clinicians in selecting optimal vascular access and in deciding when to advise patients to begin dialysis.