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was 21% at 10 years and according to the Karnofsky index, most of our patients require ongoing help and frequent medical care. The average duration of dialysis was 47.3 months (2-192 months). 44 patients (81%) had a rhythm of 3 sessions per week, while the remaining 19% were dialyzed twice a week with an average duration of the session of 3.7 hours. Most of our patients (82%) had an arteriovenous fistula (AVF), 5 patients (9.4%) were dialyzed via a femoral valve and 5 patients via a jugular catheter. Most of our patients were anemic with an average hemoglobin level of 8.9 g / dl, hypocalcemia was present in 23 patients (43.3%), hyperphosphatemia in 16 patients (30.1%) and secondary hyperparathyroidism in 22 patients (41.5%). The main complications in hemodialysis were stroke in 3 patients (5.6%), pericarditis in 4 patients (7.5%) and coronary insufficiency in 8 patients (15.1%). Regarding cognitive disorders, 2 patients (3.7%) had dementia, 6 patients (11.3%) had depression, 11 patients (20.7%) had anxiety, and 32 patients (60.3%) had insomnia. Two cases of death were noted whose etiology was a rupture of a false aneurysm in one patient and wet gangrene in the other patient. Conclusions: The elderly are a population of frail patients with high comorbidity and autonomic disorders. Chronic hemodialysis treatment is a heavy treatment that requires regular monitoring to avoid particular complications of the elderly.Introduction: Current literature suggests the arteriovenous fistula (AVF) to be the preferred type of vascular access for hemodialysis. However, AVFs have significant and potentially deleterious effects on cardiac functions particularly in the setting of preexisting heart disease. The aim of this study is to compare the clinical and echocardiographic evolution after creation of a proximal AVF and a radial AVF. Methods: We conducted a retrospective descriptive study including all chronic hemodialysis patients through AVF. Group 1 (G1) included patients with proximal AVF and group 2 (G2) patients with radial AVF. Data collected included demographics, Clinical Status, vascular access type, and metabolic parameters. Data were entered and analyzed using SPSS software. Chi-squared test with a level of significance of 0.05 was used for the qualitative variables. Results: Twenty-four patients were collected in G1 and the average age was 55 years. G2 included 13 patients with a mean age of 44 years. Systolic blood pressure decreased after AVF creation in both groups (G1: 62.5%, G2: 45%, NS). A dyspnea was noted in 70% of cases of G1 and 38.4% of cases of G2 (NS). The interventricular septum was thickened in 20.8% of cases of G1 and 38.4% of G2 (NS). Left ventricular (LV) dilatation was observed in both groups with LV diastolic telegram diameter increase of 58% in G1 versus 10% in G2 (p ¼ 0.04). A decrease in LV ejection fraction was found in 62.5% in G1 and 46.1% in G2 (p ¼ 0.066). The major cardiac complications in G1 were acute coronary syndrome in 5 patients and atrial fibrillation in 4 cases after an average of...