Hemodialysis Access for Chronic Renal Failure

Abstract

The well-functioning vascular access (VA) is the mainstay to perform an efficient hemodialysis. There are three types of vascular access that consist of arteriovenous fistula, arteriovenous graft and central venous catheters. Many guidelines from different countries recommend the fistula first and the catheter late approach because fistula has high patency rates, longevity and lowest comorbidity and mortality. Also, the upper extremity access should be preferred than lower extremity access. However, the VA- related outcomes may be optimized by considering individual patient characteristic, comorbidity and life expectancy. The good team should include a nephrologist, vascular surgeon and dialysis nurse team. Early referral and venous preservation lead to the good outcomes.