Abstract: 【Abstract】Objective To investigate the vascular access situation in elderly maintenance hemodialysis(MHD) patients in Bengbu area. Methods A total of 130 MHD patients over 60 years old were enrolled as the elderly group, and a total of 162 MHD patients less than 60 years old were recruited as the non-elderly group. The distribution of vascular access methods at the beginning of hemodialysis and during MHD period were compared between the two groups. Clinical data in elderly group were compared between the patients using internal fistulas and those using venous catheters. Results Of the vascular access methods in elderly
group, arteriovenous fistula (AVF) accounted for 62.3%, arteriovenous graft (AVG) for 0.8%, and tunneled cuffed catheter (TCC) for 36.9%. The proportion of using provisional venous catheter as vascular access at first was relatively high in both elderly group and non-elderly group, and was higher in elderly group than in non-elderly group (χ2=18.945, P＜0.001). The proportion of using AVF as vascular access at first was higher in non-elderly group than in elderly group (χ2=17.505, P＜0.001). The proportion of using TCC as vascular access was higher in elderly group than in non-elderly (χ2=27.930, P＜0.001). In elderly group, the concentrations of hemoglobin and albumin were higher in the patients with AVF than those with TCC (t=-7.712 and -6.323 respectively; P＜0.001); the ratio of diabetes and the concentrations of serum hsCRP and creatinine were lower in the patients with AVF than those with TCC (t=14.857, -3.172 and 4.626 respectively, P＜0.001, P=0.002 and P=0.033 respectively). Conclusion The constituents of vascular access methods for elderly MHD patients in Bengbu area were unsatisfactory to the targets recommended by the Expert Consensus on Vascular Access in China. The proportion of using AVF at the beginning of hemodialysis and during MHD was lower, while this vascular access method has less effects on microinflammatory state, nutritional status
and anemia of the patients. Therefore, AVF should be adopted as the first choice of vascular access, on which individualized management can then be taken.

Key words: Hemodialysis, Elderly, Vascular access, Arteriovenous fistula