Vascular Access-renal replacement and dialysis

AV fistula

Pros

• Highest patency
• Lowest risk of bacteremia
• Lowest mortality (JASN 2013;24:465) Cons
• Long maturation time (2–6 mo)
• Primary nonfunction (20%)

AVgraft

• Easier to create than AVF
• Maturation time (2–3 wk) Cons:
• Poor 1° patency, often requiring thrombectomy or angioplasty

Catheter

• Immediate use
• Use as bridge to AVF/AVG Cons:
• Highest risk of bacteremia
• ↓ blood flow → ↓ HD efficiency