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The article by Goldstein and Gupta¹ in the October 2003 issue of the ARCHIVES devoted to aging made for interesting reading. The authors took great efforts to study the utility of artery flow and diameter in patients with end-stage renal disease (ESRD); they state that the radial artery carried sufficient flow to support a shunt or fistula in three quarters of cases in a study of 211 patients with a mean age of 49.8 years. As a geriatrician and nephrologist, I was particularly interested in the data and considered the effect of age on artery flow and utility.

In this context, it is worth emphasizing that more than half the US adults starting hemodialysis today are older than 65 years; the median age of persons with incident ESRD has gone up from 54 to 65 years, and rates of new ESRD cases are consistently highest in the 75+ age group.² . . . [Full Text of this Article]

T. S. Dharmarajan, MD

Correspondence: Dr Dharmarajan, 31 Pheasant Run, Scarsdale, NY 10583 (dharmarajants@yahoo.com).