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Objective: Aim to provide experiences for the long-term patency and prevention of complications of vascular access in the elderly maintenance hemodialysis patients(MHD),we analyzed the clinical characteristics of the elderly hemodialysis patients(≥65 years old)in our center.Methods: MHD patients were divided into two groups according to the age,the elderly group(≥65 years old,n=116),and the young group(<65 years old,n=130).The Types of vascular access and the characteristics of construction and use of the vascular access were analyzed.Results:The proportion of catheter was higher in the elderly group(44% vs 10%,P<0.01),women tend to use catheter regardless of the age.The rate of emergency dialysis was higher in the elderly patients(19% vs 5.4%,P<0.01).The prevalence of diabetes,cardiovascular disease and peripheral vascular disease was significantly higher in the elderly,otherwise,the ratio of fistula and catheter was similar between the elderly patients combined with diabetes or peripheral vascular disease(50.7% vs 49.3%,P>0.05).The levels of BMI,hemoglobin and albumin were significantly lower in the elderly catheter group(P<0.01).In the elderly groups,fistula was established in elbow in 5 cases,significantly higher than the young group(8.3% vs 0.88%,P<0.001).The primary patency of fistula was less than the young group,but the cumulative patency was similar after interventions between the two groups.The proportion of PTA or surgical treatment was higher than the young group(P<0.01).The prevalence of disabilities of fistula mature were higher in the elderly(10% vs 3.5%,P<0.01).The rate of the cuffed catheter was higher in the elderly group.There were no significant differences between the primary catheter patency and the cumulative catheter patency in the two groups,otherwise,the incidence of catheter-related infections was increased in the elderly(P<0.05).Conclusion: The catheter was used more frequently in the elderly patients.The proportion of catheter-related infections was higher than the young,but the patency of catheter was close.The fistula in elbow was constructed more in the elderly patient.In the elderly,the patency and the maturation of the fistula were inferior to the young,that was close to the young after active interventions.This study suggests that age is an adverse factor and there were distinctions in the selection,construction and utilization of vascular access in the elderly hemodialysis patients.