Ko GJ, et al. - Researchers sought to determine the optimal vascular access type in octogenarians and older (≥80 years) hemodialysis patients given their limited life expectancy and lower arteriovenous fistula (AVF) maturation rates. They examined incident hemodialysis patients <80 vs ≥80 years of age receiving care in a large national dialysis organization during 2007–2011, to compare patterns of vascular access type conversion in 1 year following dialysis initiation. Using multivariable survival models, they also assessed the link between vascular access type conversion and mortality among a subcohort of patients ≥80 years of age. Mortality seen with the placement of an AVF from a central venous catheter (CVC) within the first year of dialysis was found to be similar to that seen with initial AVF use among incident hemodialysis patients ≥80 years of age. Among elderly hemodialysis patients, an acceptable option may be initial CVC use with later placement of an AVF.